脑卒中患者急性期脑血管血液动力学变化特征(英文)  

Characteristics of the cerebral vascular hemodynamic changes in acute stroke patients

作　　者：杨渤生[1] 林航[1] 洪一飞[1] 王桂清[2] 曹奕丰[2] 冯春红[2] 

机构地区：[1]解放军南京军区福州总医院神经内科,福建省福州市350025 [2]上海市脑血管病防治研究所,上海市201318

出　　处：《中国临床康复》2005年第9期228-229,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：背景:研究正常人群、脑卒中高危人群、脑卒中发生前后脑血管血液动力学(cerebralvascularhemodynamicindex,CVHD)检测结果的分布特征及其变化规律,尤其是脑卒中发生前的CVHD特征,是提高临床脑供血不足的诊断效能以及脑卒中预警敏感度和特异度所必须研究的课题。目的:探讨脑卒中急性期患者CVHD指标的特征,为脑卒中早期评估和康复介入提供理论依据。设计:以患者为研究对象,病例分析的观察性研究。单位:一所军区总医院的神经内科和一所市级脑血管病防治研究所。对象:2001-06/12解放军福州总医院神经内科住院的脑卒中急性期患者55例,男38例,女17例。方法:在发病1周内进行CVHD检测,分析各检测指标的特征。主要观察指标:55例脑卒中急性期患者CVHD积分值、血压和脑血管血流动力学检测指标。结果:全部患者的CVHD的积分值均在75分以下,中位数32.5分。与正常男性70岁年龄组CVHD测定值比较,平均血流速度、血流量、最大血流速度、最小血流速度和舒张压与临界压的差值均有明显降低(P<0.01),而脉搏波速、外周阻力、特异性阻抗以及临界压水平均有显著升高(P<0.01)。结论:脑卒中发病1周内脑血管血液动力学积分值降低,各项检测指标均有明显的改变。CVHD检测能敏感地反映脑血管供血不足或预警脑卒中发生。BACKGROUND:The understanding about characteristics and variation trends of ce rebral vascular hemodynamic indexes in high- risk stroke population,in prior an d post- stroke period patients as well as in normal people,particularly the cer ebral vascular hemodynamic index(CVHD) prior to stroke can improve diagnosis eff iciency of stroke and increase sensitivity and specificity of stroke diagnosis. OBJECTIVE:To study the features of CVHD in acute stoke,in order to provide ev idences for early evaluation and rehabilitation intervention. DESIGN:Case analysis and observational study based on patients.SETTING:A neurological department in a general hospital of military area comm and of Chinese PLA and a prevention and cure institute of cerebrovascular diseas es.PARTICIPANTS:Totally 55(male 38,female 17) inpatients in the Neurological Dep artment of Fuzhou General Hospital of Chinese PLA from June to December 2001 wer e enrolled in the study.METHODS:CVHD was measured during the first week after onset and the data were analyzed. MAIN OUTCOME MEASURES:The CVHD,blood pressure and cerebral vascular hemodynam ic parameters. RESULTS:The CVHD of each patient is below 75,median 32.5. The mean velocity,b lood flow,maximum velocity,minimum velocity and difference between diastolic and critical pressures were lower than corresponding ones of healthy men in seventi es(P< 0.01). And the pulse wave velocity,peripheral resistance, specific impedan ce and critical pressure increased(P< 0.01). CONCLUSION:During the first week after stroke,the CVHD decreases and many hem odynamic parameters alters significantly.Examination of CVHD can reveal cerebral circulation insufficiency or predict an attack of cerebral stroke.

关 键 词：脑血管意外 血液动力学 血压 

分 类 号：R743[医药卫生—神经病学与精神病学]