短暂性脑缺血发作患者脑血管超声评估与治疗选择  

Cerebrovascular ultrasound assessment and clinical therapy selection in patients with transient ischemic attack

作　　者：蔡秀英[1] 黄亚波[2] 孔小明[3] 赵红如[1] 段晓宇[1] 惠品晶[4] 刘一之[5] 王中[2] 方琪[1] 

机构地区：[1]苏州大学附属第一医院神经内科,215006 [2]苏州大学附属第一医院神经外科,215006 [3]苏州大学附属第一医院急诊科,215006 [4]苏州大学附属第一医院TCD室,215006 [5]苏州大学附属第一医院介入科,215006

出　　处：《中国神经免疫学和神经病学杂志》2013年第4期260-262,266,共4页Chinese Journal of Neuroimmunology and Neurology

基　　金：江苏省卫生厅预防医学科研课题(Y201036)

摘　　要：目的评价脑血管超声检查在短暂性脑缺血发作(TIA)患者的病因诊断与治疗方法选择中的作用。方法对79例确诊TIA患者的临床特征、脑血管检查结果和治疗方法的选择进行分析。结果 62例(78.5%)患者症状持续时间<1h;发作次数≥2次的病例65例(占82.3%),且多存在高血压、糖尿病等血管病变基础。颈动脉超声发现55例(69.6%)的患者存在血管病变,经颅多普勒(TCD)结果提示64例(81.0%)患者有血管损害。TCD与磁共振血管显影(MRA)、CT血管造影(CTA)及数字减影血管造影(DSA)的符合率分别是70.9%(22/31)、52.2%(12/23)、75.0%(15/20)。结论血管病变是TIA的重要原因,早期血管影像学检查是确诊和临床干预治疗的重要依据,血管超声是及时便捷的筛选方法。Objective To evaluate the effect of cerebrovascular ultrasound on etiological diagnosis and treatment selection in patients with transient ischemic attack（TIA）. Methods Seventy-nine cases of TIA were collected.The clinical features,blood vessels detection and treatment options were recorded. Results In 78.5% of the patients 62 cases,the symptoms duration was less than 1 h;the number of attacks≥ 2 times accounted for 82.3%（65 cases）,and most patients suffered from hypertension,diabetes,and other risk factor.Carotid ultrasound examination revealed that 55 patients（69.6%） suffered from vascular diseases and transcranial Doppler（TCD） results suggested that 64 patients（81.0%） had vascular lesions.The coincidence rates between TCD results and the magnetic resonance angiography（MRA）,CT angiography（CTA） and digital subtraction angiography（DSA） were 70.9%（22/31）,52.2%（12/23）,and 75.0%（15/20）,respectively. Conclusions Vascular lesions is an important reason for TIA.Early vascular imaging is the main basis of the diagnosis and clinical intervention.Vascular ultrasound is the timely and most convenient screening method.

关 键 词：短暂性脑缺血发作 颈动脉超声 经颅多普勒 临床治疗 

分 类 号：R743.3[医药卫生—神经病学与精神病学]