超声评价脑血流自身调节功能时不同脑血管阻力变化差异性的研究  

Study on Changes of Vascular Resistances in Different Cerebral Arteries by Sonography for Evaluating Cerebral Autoregulation

作　　者：刘杰[1] 曹铁生[1] 张宏喜 段云友[1] 袁丽君[1] 刘禧[1] 李莹莹[1] 

机构地区：[1]解放军第四军医大学唐都医院超声科,西安市710038 [2]陕西省华阴市,荣誉军人康复医院超声科

出　　处：《中国超声医学杂志》2006年第12期896-899,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的观察冷加压试验(CPT)下多普勒超声所测不同脑血管阻力变化的差异性,为通过多普勒超声评定脑血流的自身调节功能选择合适的脑血管。方法记录CPT中27例健康青年人右侧大脑中动脉、右侧颈内动脉和右侧椎动脉的时间平均最大流速(Vm),并同步记录血压,计算相对血管阻力(VR),进行统计学分析。结果CPT中,右侧大脑中动脉(RMCA)、右侧颈内动脉(RICA)和右侧椎动脉(RVA)的VR均随着平均动脉压(MAP)的上升而明显增加,其中RICA的VR增加率与MAP上升率基本一致,而RMCA和RVA的VR增加率略小于MAP的上升率(P<0.05)。结论在CPT中,交感神经兴奋对颈内动脉内径的影响比对大脑中动脉和椎动脉内径的影响要小,因此,颈内动脉Vm的变化能较准确地反映其实际血流量的变化。颈内动脉是多普勒超声评定脑血流自身调节功能最为适宜的脑血管。Objective To compare the changes of different cerebrovascular resistances derived from Doppler measurement during cold pressor test （CPT）, and to identify the proper cerebral artery for clinical assessment of cerebral autoregulation by Doppler sonography. Methods The time-averaged maximal velocities （Vm）of right middle cerebral artery （RMCA）, right internal carotid artery （RICA） and right vertebral artery （RVA） in twenty-seven hcalthy young adults during CPT were recorded. The arterial blood pressures were also recorded simultaneously. The vascular resistances （VR） were calculated and statistically analyzed. Results During CPT, the VR of RMCA, RICA and RVA ascended obviously with the increase of mean arterial pressures （MAP）, while the increase of VR in RMCA and RVA was slightly less than the increase of MAP （P〈0.05）. Conclusions During CPT, the diameter of ICA was less affected by sympathetic activation than that of MCA or VA, so the Vm of ICA reflected its actual flow volume more accuralely. The internal carotid artery is the most proper cerebral artery for clinical assessment of cerebral autoregulation by Doppler sonography.

关 键 词：脑血流自身调节 冷加压试验 多普勒超声 血管阻力 

分 类 号：R445.1[医药卫生—影像医学与核医学]