颈内动脉迂曲的危险因素及对脑血流动力学的影响  

Risk factors and influence of tortuous internal carotid artery on cerebral hemodynamics

作　　者：赵海霞[1,2] 周振华[1] 刘渠[1] 陈莉[1] 陈康宁[1] 

机构地区：[1]第三军医大学西南医院神经内科,重庆400038 [2]武警山西总队医院神经内科,太原030006

出　　处：《武警医学》2012年第7期560-562,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的探讨颈内动脉迂曲的危险因素及对脑血流动力学的影响。方法缺血性脑卒中患者行全脑血管造影术,筛选出颈内动脉迂曲而无狭窄或闭塞的患者,分析其临床资料,观察大脑中动脉显影时间,并用经颅彩色多普勒对大脑中动脉血流动力学进行评价,同时与颈内动脉无迂曲患者进行比较。结果年龄和高血压是颈内动脉迂曲的危险因素。颈内动脉迂曲患者大脑中动脉显影时间为(2.08±0.34)s,明显长于无迂曲组的显影时间(1.84±0.24)s,大脑中动脉收缩期血流速度为(75.77±15.09)cm/s,平均血流速度为(49.60±10.37)cm/s,明显低于无迂曲患者的收缩期血流速度和平均血流速度[(107.52±24.17)cm/s;(65.38±16.22)cm/s]。结论颈内动脉迂曲与年龄及高血压关系密切,并可导致血流动力学改变。血管迂曲所致血流动力学障碍可能是其导致卒中的原因之一。Objective To study the effect of tortuous internal carotid artery on cerebral hemodynamics.Methods Digital subtraction angiography was performed in cerebral ischemic stroke patients in order to screen out those with tortuous internal carotid artery but without stenosis or blocking of the artery.Then,the information of the patients screened out was analyzed and the developing time of the middle cerebral artery was observed.Finally,haemodynamics of the middle cerebral artery with transcranial color Doppler was evaluated.Results Compared with patients without tortuous internal carotid artery,those with tortuous internal carotid artery were older and more likely to be patients of hypertension.In addition,the developing time of their middle cerebral artery was obviously extended [patients with the tortuous artery（2.08±0.34） s in contrast to patients without the tortuous artery（1.84±0.24） s].Their systolic blood flow velocity was（75.77±15.09）cm/s and the mean velocity of blood flow was（49.60±10.37）cm/s,slower than those in the control group [（107.52±24.17）cm/s and（65.38±16.22）cm/s],and the vascular pulsation index and resistance index were both lower than those in the control group.Conclusions Tortuous internal carotid artery is closely related to age and hypertension,causing changes in cerebral hemodynamics.Cerebral hemodynamic changes in patients with tortuous internal carotid artery may be one of the causes of stroke.

关 键 词：全脑血管造影 颈内动脉迂曲 经颅彩色多普勒 脑血流动力学 

分 类 号：R74[医药卫生—神经病学与精神病学]