56例缺血性脑卒中急性期患者经颅多普勒检测的临床分析  

Value of transcranial color Doppler in the diagnosis of acute ischemic stroke： analysis of 56 cases

作　　者：许伟[1] 邹友权[1] 曾维烁[1] 

机构地区：[1]广东省梅州市人民医院功能科,514000

出　　处：《中华神经医学杂志》2008年第10期1063-1066,共4页Chinese Journal of Neuromedicine

摘　　要：目的研究急性缺血性脑卒中患者经颅多普勒（TCD）超声检测的动态变化，探讨其变化规律在临床上的意义。方法选择56例单侧大脑中动脉（MCA）缺血性脑卒中患者于入院即刻、第2、4、7、14、28天进行TCD动态检测分析，记录各血管频谱波形情况及平均血流速度（Vm）、脉动指数（P1）。结果入院即刻TCD检测发现异常率较高，且患侧VmMCA降低，VmACA升高，分别与自身健侧及对照组比较差异有统计学意义（P〈0．05）。与正常对照组VmMCA{66．51[56．64，71．43]cm／s}比较，主干闭塞组{23．45[7．55，38．72]cm／s}、深穿支闭塞组{52．53[45．56，66．93]cm／s}、皮层支闭塞组{38．44[31．67，52．45]cm／s}VmMCA均明显降低，差异有统计学意义（P〈0．05）。动态观察发现治疗后患侧VmMCA明显增高，均较人院即刻比较差异有统计学意义（P〈0．05）；PIMCA值逐渐增高，与入院即刻及对照组比较差异有统计学意义（P〈0．05）。结论TCD检测在缺血性脑卒中急性期的早期诊断中具有较高价值。Objective To investigate the dynamic changes of cerebral blood flow defined by transcranial color Doppler （TCD） and their correlation with the severity and prognosis of acute ischemic stroke. Methods Fifty-six consecutive patients with the primary onset of acute ischemic stroke received dynamic examinations with TCD upon admission and on days 2, 4, 7, 14 and 28 following the onset, and the mean blood flow velocity and pulsatility index were recorded. Results TCD examinations upon admission revealed high abnormal rate. The mean blood flow velocity of the middle cerebral artery （VmMCA） on the lesion side was significantly lower than that on the contralateral side and that of the control group. The blood flow velocity of the anterior cerebral artery （VmACA） on the lesion side was significantly increased compared with that on the contralateral side and that of the control group. VmMCA of main stem occlusion group {23.45 [7.55,38.72] cm/s}, central branch infarction group {52.53 [45.56,66.93] cm/s}, and cortical branch of cerebral arteries infarction group {38.44[31.67,52.45] cm/s} was significantly lower than that of the control group {66.51 [56.64,71.43] cm/s}. VmMCA gradually increased in these patients after the treatment, showing significant difference from that measured upon admission. The PI of the middle cerebral artery increased after admission, with significant difference from that recorded on admission and that of the control group. Conclusion TCD has high diagnostic value for ischemic stroke and may help evaluate the severity of the condition and the prognosis of the patients.

关 键 词：缺血性脑卒中 经颅多普勒 

分 类 号：R743.3[医药卫生—神经病学与精神病学]