大脑中动脉粥样硬化性狭窄患者脑血管自动调节能力分析  

Analysis of Cerebrovascular Autoregulation in Patients with MCA Atherostenosis

作　　者：刘俊艳[1] 魏娟红[2] 罗艳利[2] 

机构地区：[1]河北医科大学第三医院神经内科,石家庄市050051 [2]河北医科大学第三医院老年病科,石家庄市050051

出　　处：《中国超声医学杂志》2007年第10期737-740,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的研究有症状及无症状大脑中动脉粥样硬化性狭窄(MCAS)患者的脑血管运动反应性,探讨脑血管自动调节能力对缺血性卒中的预警作用。方法63例有症状及31例无症状MCAS患者作为研究对象,以36例年龄、性别相匹配的健康人作为对照组。所有被研究者常规接受经颅多普勒超声(TCD)检测后进入TCD8.0监测软件,连续记录屏气前、屏气末双侧MCA血流速度及屏气时间,计算屏气指数(BHI)。结果94例患者共140条大脑中动脉(MCA)狭窄。症状组患者病灶侧、非病灶侧及无症状狭窄组患者病变MCA的屏气指数(BHI)分别为(0.93±0.45)%/s,(1.22±0.40)%/s,(1.13±0.56)%/s,均显著低于健康对照组[(1.53±0.80)%/s,P<0.01)];且症状组患者病灶侧BHI与非病灶侧及无症状狭窄组患者相比也明显降低(P<0.05),但后两者间无统计学差异(P=0.688)。结论有症状及无症状MCAS患者脑血管自动调节能力是降低的,监测脑血管自动调节能力可以早期预警缺血性卒中的发生风险。Objective To assess cerebral vasoreactivity in patients with symptomatic and asymptomatic middle cerebral artery atherostenosis （MCAS） and to understand the relationship of cerebrovascular autoregulation and ischemic stroke. Methods Totally 63 symptomatic and 31 asymptomatic MCAS patients were recruited as the study group, 36 age- and sex-matched healthy individuals as the control group. All the subjects received the examination with Spencer holding probe to monitor bilateral MCA flow velocity and Doppler spectra during breath-holding （breath-holding time about 30 seconds） were recorded and detected by TCD 8.0 software, then breath-holding index （BHI） were calculated. Results Criminal side MCA BHI in symptomatic patients was significantly lower than that of irresponsible side in asymptomatic patients and that of control group （0.93±0.45 %/s, 1.22±0.40 %/s, 1.13± 0. 56 %/s vs 1.53±0.80 %/s, P〈0.01）; Moreover, MCA BHI of irresponsible side and asymptomatic patients were also lower than that of the control group, but there were no significantly difference between the former two （P= 0. 668）. Conclusions The cerebrovascular reactivity was markedly impaired in patients with symptomatic and asymptomatic MCAS. To assess cerebral autoregulation through TCD might be an important means for predicting ischemic stroke.

关 键 词：脑血管反应性 动脉粥样硬化 大脑中动脉 闭塞性病变 

分 类 号：R743.3[医药卫生—神经病学与精神病学]