TCD监测微栓子信号在缺血性脑血管疾病患者中的临床意义  

Relationship between Microembolic Signal and Ischemic Cerebrovascular Disease

作　　者：洪梅[1] 宋毅峰[1] 郭涛[1] 胡豫[1] 魏文宁[1] 宋善俊[1] 刘芳[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院血液科,武汉430022

出　　处：《中国康复》2009年第5期312-314,共3页Chinese Journal of Rehabilitation

基　　金：卫生部医疗机构临床学科重点项目资助(2004-2006)

摘　　要：目的:探讨经颅多普勒(TCD)监测微栓子信号(MES)在缺血性脑血管疾病中的临床意义及凝血纤溶异常。方法:缺血性脑血管疾病患者69例,其中脑血栓43例,短暂性脑缺血(TIA)26例为脑血管病组和43例同年龄高血压、糖尿病或高血脂患者为对照组,分别监测TCD及检测凝血纤溶纤维蛋白原(Fg)和D-二聚体(D-D浓度)。结果:脑血管病组的MES检出率较对照组显著增高,脑血栓组的MES检出率与TIA组无显著性差异。脑血栓组的Fg水平较对照组显著增高,TIA组的Fg水平与对照组无显著性差异,脑血栓组Fg水平较TIA组显著升高。脑血栓及TIA组的D-D浓度均较对照组显著增高,脑血栓组D-D浓度较TIA组显著升高。Logistic回归分析显示MES和高血压进入脑血管病发生的危险因素。结论:MES与缺血性脑血管疾病密切相关,可能是缺血性脑血管疾病的独立危险因子。Objective：To investigate the clinical significance of microembolic signal （MES） monitoring by transcranial Doppler （TCD）, and dysfunction of coagulation and fibronolysis in ischemic cerebrovascular diseases. Methods：The data of 69 patients with ischemic cerebrovascular diseases and 43 controls were collected, including their sex, age, disease history, X-ray plain and frequency spectrum of TCD. The levels of fibrinogen （Fg） and D-Dimer （D-D） were determined. Results：There was significant difference in the MES detection ratio between ischemic eerebrovascular disease group [including cerebral thrombosis group and transient ischemia attack （TIA） group）] and control group, but there was no significant difference between the cerebral thrombosis group and TIA group. MES and hypertension were two variables in the Logistic model of ischemie recurrence in statistics. The level of Fg was significantly higher in isehemic cerebrovascular disease group, especially in cerebral thrombosis group than in control group, but there was no difference between TIA group and control group. Moreover, the level of D-D in disease group was also significantly higher than in control group. Conclusion：There was a close association between the MES and ischemic cerehrovascular disease. MES may be an independent risk factor of occurrence of ischemic cerebrovascular disease.

关 键 词：微栓子信号 缺血性脑血管疾病 纤维蛋白原 D-D 

分 类 号：R445.1[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]