经颅多普勒超声对早期脑动脉硬化症诊断价值的探讨  

Diagnostic value of transcranial Doppler ultrasound in early stage cerebral arteriosclerosis

作　　者：田发发[1] 姚凤红[1,2] 宋明谕[1] 傅晶晶[1] 尹蓉[1] 党静[1] 陆嘉茵[1] 

机构地区：[1]中南大学湘雅医院神经内科,长沙410008 [2]中关村医院神经内科,北京100190

出　　处：《中南大学学报（医学版）》2012年第5期495-499,共5页Journal of Central South University ：Medical Science

摘　　要：目的:探讨经颅多普勒超声(transcranial Doppler ultrasound,TCD)的频谱形态对早期脑动脉硬化症诊断的临床意义。方法:收集早期脑动脉硬化症患者共50例,同时收集同时期无明显神经系统阳性体征的患者50例为对照组。用2 MHz脉冲多普勒探头探测双侧大脑中动脉(middle cerebral artery,MCA)、基底动脉(basilar artery,BA),在TCD频谱中选取单心动周期的血流频谱,确定每个心动周期的起始点(ts)、重脉搏切迹点(ti)、终结点(te)和血流速度达到峰值的时间点(tp),计算ts至tp的时距(Tp)、ts至ti的时距即心室收缩期(Ti)、ts至te的时距即心动周期(T),计算Tp在心室收缩期和整个心动周期中所占的比值(Tp/Ti,Tp/T)。Tp,Tp/Ti和Tp/T分别被命名为达峰时间(time to peakvelocity,TPV)、峰时指数-1(peak-time index 1,PTI-1)和峰时指数-2(PTI-2)。结果:与对照组相比,疾病组颅内血管血流速度、搏动指数(pulsatility index,PI)、阻力指数(resistance index,RI)和收缩期峰值血流速度与舒张末期流速比值(systolic peak blood flow to end diastolic blood flow,S/D)均无明显差异(P>0.05);疾病组BA,LMCA,RMCA的TPV均显著延长,PTI-1,PTI-2显著增大(P<0.01);达峰指数(PTI-1,PTI-2)和PI,S/D无显著相关(P>0.05)。结论:TPV,PTI-1和PTI-2可能是反映早期脑动脉硬化的敏感指标。Objective： To investigate the diagnostic value of transcranial Doppler ultrasound in early stage cerebral arteriosclerosis. Methods： We selected 50 patients with early cerebral arteriosclerosis as the disease group. At the same time we selected another 50 patients as a control group with no significant symptoms in the nervous system. By 2 MHz pulse Doppler probe through double-temporal windows and pillow windows Basilar artery （BA）, the bilateral middle cerebral artery （MCA） was detected. In the TCD spectrum, we selected the spectrum of a single-family cardiac cycle, identified the starting point （ts）, pulse-incisure point （ti）, end point （re）, and the peak velocity （tp）, measured the time of the spectrum starting point to the peak velocity （Tp） and calculated the time required for the peak velocity in the share ofventricular systolic （Tp/Ti）, the time required for the peak velocity in the share of the whole cardiac cycle （Tp/T）. Tp, Tp/Ti and Tp/T were respectively named as time to peak velocity （TPV）, peak-time index-1 （PTI-1） and peak-time index-2 （PTI-2）. All data were analyzed by SPSS 13.0. Results： There was no significant difference in blood vessel velocity, PI, RI and S/D of BA and RMCA （P〉0.05） between the control group and the disease group. Compared with the control group, TPV of the BA, LMCA and RMCA significantly extended, PTI-1 and PTI-2 of BA, LMCA and RMCA increased significantly in the disease group （P〈0.01）. In the disease group, there was no significant correlation between peak time index and PI, S/D （P〉0.05）. Conclusion： TPV, PTI-1 and PTI-2 are sensitive indicators of early stage cerebral arteriosclerosis.

关 键 词：经颅多普勒超声 脑动脉硬化症 达峰时间 达峰指数 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]