慢性进展性大脑中动脉主干闭塞患者的脑血流动力学研究  

Cerebrovascular hemodynamics study in patients with chronic progressive occlusion of middle cerebral artery stem

作　　者：张雄伟[1] 张以善[1] 王开平[1] 王翠玉[1] 李曼[1] 李秋俐[1] 金文静 

机构地区：[1]解放军第二炮兵总医院神经内科,北京100088 [2]解放军第535医院特诊科,湖南怀化418008

出　　处：《中国现代医学杂志》2007年第23期2914-2917,共4页China Journal of Modern Medicine

摘　　要：目的探讨慢性进展性大脑中动脉主干闭塞患者的脑血流动力学改变。方法对75例经数字减影血管造影或磁共振血管成像证实的大脑中动脉主干闭塞患者(患者组)和80例无大脑中动脉病变患者(对照组)行经颅多普勒超声检测。结果患者组60例(80%)闭塞侧大脑中动脉深度范围血流速度明显降低[平均流速(23±5)cm/s]。70例(93%)病侧大脑前动脉血流速度代偿性增快,两侧大脑前动脉血流速度比值(1.49±0.23)明显高于对照组(1.03±0.11),两组间差异有显著性(P<0.01)。45例(60%)病侧大脑后动脉血流速度代偿性增快。患者组未发现其他侧支循环通路开放的血流表现。结论经颅多普勒超声有助于了解大脑中动脉主干闭塞患者的脑血流动力学改变,为评价病情发展和预后,了解颅内侧支循环代偿状况,更深入研究缺血性脑血管病的发病机制提供了重要的客观依据。[Objective] To explore the cerebrovascular hemodynamics changes in patients with chronic progressive occlusion of middle cerebral artery stem. [Methods] Seventy-five patients with middle cerebral artery stem occlusion determined by digital subtraction or MR angiography were selected to serve as patient group and eighty patients without disease of middle cerebral artery stem were selected as controls. All patients were measured by transcranial doppler（TCD）. [Results] The blood flow velocity of occlusion side MCA sample depth remarkably reduced [mean flow velocity （23±5）ends] in 60 patients （80%）. TCD showed blood flow velocity compensative acceleration of the occlusion side anterior cerebral artery in 70 patients （93%）. The blood velocity ratios of anterior cerebral artery for the patient group （1.49±0.23） was significantly higher than ratios for controls （1.03±0.11）. There was a significant difference between the two groups （P 〈0.01）. Forty-five patients （60%） showed blood flow velocity compensative acceleration of the occlusion side posterior cerebral artery. The blood flow appearance of other collateral circulation pathway was not found in the patient group. [Conclusions] TCD might further help to know the cerebrovascular hemodynamics changes in patients with chronic progressive occlusion of middle cerebral artery stem. It was suggested that TCD might be important and objective index in evaluating the patient＇s condition and prognosis, in understanding the compensative state of collateral circulation, in studlng deeply the pathologic mechanism of ischemic cerebrovascular disease.

关 键 词：超声检查 经颅多普勒 动脉闭塞 侧支循环 

分 类 号：R445[医药卫生—影像医学与核医学]