缺血性脑卒中急性期经颅多普勒超声指标的动态改变及其评估价值(英文)  

Dynamic changes in transcranial Doppler ultrasound findings and their value in ischemic stroke evaluation during acute stage

作　　者：朱榆红[1] 陈纯[1] 高平[1] 保明芳[1] 李燕[1] 

机构地区：[1]昆明医学院第二附属医院神经内科,云南省昆明市650101

出　　处：《中国临床康复》2005年第41期122-125,共4页Chinese Journal of Clinical Rehabilitation

摘　　要：背景:经颅多普勒超声能无创性检测颅内动脉的血流信号,较为客观的反映脑血流动力学改变,有助于了解血管闭塞及狭窄的程度、部位、范围、侧支循环以及闭塞后再通的情况,对缺血性脑血管疾病的早期诊断、病情判断、预后评估具有重要价值。目的:通过对缺血性脑卒中急性期的经颅超声多普勒动态观察,与脑电图、脑电图地形图、头颅计算机断层扫描等进行对比研究,以探讨经颅超声多普勒对缺觑性脑卒中早期评估的价值,观察经颅超声多普勒与脑电图、脑电图地形图及神经功能缺损评分之间的相关性以判断病情指导治疗。设计:病例-对照实验。单位:昆明医学院第二附属医院神经内科。对象:选择2001-10／2002-03在昆明医学院第二附属医院神经内科接受住院治疗的缺血性脑卒中23例患者及同期选择年龄性别相匹配的门诊健康体检者30人为对照组。方法:①所有患者均于入院即刻行床旁经颅多普勒超声检查,并于入院后第2,4,7天复查,所有正常对照者均于体检当天行经颅多普勒超声检查。②所有患者均在入院当天行床旁脑电图及脑电图地形图检查。③所有患者于入院后即刻,入院后第3,4,7天进行神经功能缺损评分(最高得分45分,最低得分0分,0-15分为重度神经功能缺损,16-30分为中度神经功能缺损,31-45分为轻度神经功能缺损)。主要观察指标:①全部被试对象经颅多普勒超声检查结果。②缺血性脑卒中患者神经功能缺损评分、脑电图描记、脑电图地形图描记、头颅计算机断层扫描检查结果。结果:缺血性脑卒中患者23例和30名健康体检者均进入结果分析。①入院当天经颅多普勒超声异常率91．3％,高于脑电图(65．2％)、脑电图地形图(78．3％)及头颅计算机断层扫描(17．4%)。入院当天经颅多普勒超声表现为病侧大脑中动脉平均血流速度降低(34．92±13．25)cm／s (BACKGROUND： Transcranial Doppler ultrasonography （TCD） can noninvasively detect intracranial arterial blood flow signals and objectively depict changes in cerebral hemodynamics for the benefit of understanding the location, severity, and involved scope of the vascular occlusion and stenosis, as well as the development of collateral circulation and recanalization after occlusion. TCD therefore possesses important significance in the early diagnosis, severity appraisal, and prognostic evaluation of ischemic cere brovascular diseases.OBJECTIVE： To observe the dynamic changes in TCD manifestations during the acute stage of ischemic stroke in comparison with findings by electroencephalogram （EEG）, topographic EEG map, and head CT, and explore the value of TCD in early evaluation of ischemic stroke and the association of TCD findings with the other examination modalities and neurological deficit scores to facilitate the treatment.DESIGN： Case-controlled clinical trial.SETTING： The Department of Neurology of the Second Hospital Affiliated to Kunming Medical College.PARTICIPANTS： Between October 2001 and March 2002, 23 patients were admitted to the Department of Neurology of the Second Hospital Affiliated to Kunming Medical College for ischemic stroke. Thirty age-matched healthy subjects for routine physical examination were also included as the control group.after admission and re-examined on days 2, 4, and 7. The normal controls the patients were subjected to bedside EEG examination and topographic with neurological deficit scoring immediately and 3, 4, 7 days after admission. The scores ranged from 45 to 0, and the scores of 0-15 indicated mild neurological deficit, 16-30 moderate and 31-45 serious deficit.ral dysfunction, and results of EEG examination, topographic EEG mapping, and head CT.RESULTS： Totally 23 patients with ischemic stroke and 30 healthy control subjects were enrolled in this study and all were available for result analysis.these patients, significantly higher than the rats by EEG

关 键 词：脑缺血 超声检查 多普勒 经颅 脑电描记术 脑图 体层摄影术 X线计算机 

分 类 号：R743.3[医药卫生—神经病学与精神病学]