TCD频谱形态的临床意义研究  

Clinical Significance in Investigation of TCD Spectrum Contour

作　　者：柳扬[1] 朱雄超[1] 伍婷婷[1] 张玲菊[1] 黄一宁[2] 丁德云[1] 

机构地区：[1]浙江大学医学院附属第一医院神经科,杭州市310003 [2]北京协和医院神经科

出　　处：《中国超声医学杂志》2001年第7期492-495,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 :探讨 TCD的频谱形态所包含丰富的临床意义。方法 :76例慢性发病的头晕、高血压和 型糖尿病患者 ,应用 TCD 2 MHz探头经颞窗、眼窗和枕窗检测颅内血管血流 ,4MHz探头探测颈部血管血流。在 MCA、ICA和 BA血流速度系列频谱中选取单心动周期的频谱 ,确定流速最高点 (P)、频谱起始 (S)和终末点 (E) ,计算峰时延迟指数 (S- P/S- E)。同时 ,在双侧肱和股动脉处袖带法测量血压 ,计算股肱指数。统计学处理 :使用 SPSS 9.0软件包 ,Pearson法分析峰时延迟指数和股肱指数的相关性 ,配对 t检验比较前后循环峰时延迟的大小 ,多元线性回归分析峰时延迟的影响因素。结果 :峰时延迟和 TCD脉动指数无关 ,在 MCA、 ICA和 BA与股肱指数的相关系数分别为 :- 0 .42 7、 - 0 .45 9和 - 0 .34 3,P值分别为 :0 .0 0 0、 0 .0 0 0和 0 .0 0 3;MCA和 ICA与 BA峰时延迟指数的配对 t检验示 :t值 =3.333和 3.739,P值 =0 .0 0 1和 0 .0 0 0 ;行 MCA、ICA和 BA的峰时延迟指数对年龄、性别、高血压、糖尿病和股肱指数作普通 (Enter)多元线性回归分析 ,发现在前循环 ,仅有性别和股肱指数回归系数的 P值<0 .0 5 ,在后循环 ,糖尿病亦显示统计学意义 (P<0 .0 5 )。结论 :TCD速度频谱的峰时延迟与动脉硬化有关 ,但可能还受其它因素的影?Objective:The contour of TCD spectrum may possess great clinical significance as well as that of the blood flow velocity in TCD.Methods:Seventy-six cases with chronic dizziness,hypertension or diabetes mellitus type 2 were enrolled in this trial.Intracranial arteries were detected with TCD through temperal and sub-occipital windows with 2 MHz probe and extracranial arteries on the neck with 4 MHz probe.From MCA,ICA and BA,we chose a single cycle spectrum to determine the peak(P),start(S)and end(E)points.Spectrum-peak-back-shift index(SPBSI)was calculated from S-P/S-E.At the same time,we took the blood pressure from femoral and brachial arteries and calculated femoral-brachial blood pressure index(FBI).Statistical procedures:All statistical analyses were taken on SPSS 9.0 package,Pearson correlation between SPBSI and FBI,paired t-tests of SPBSI betweeen anterior and posterior circulations and multiple linear regression analysis between SPBSI and its influent factors were carried out.Results:No Correlation was found between SPBSI and PI.In MCA,ICA and BA,the correlation coefficients between SPBSI and FBI were -0.427,-0.459 and -0.343 respectively,and p values 0.000,0.000 and 0.003.T values of paired t-tests for SPBSI in MCA-BA and ICA-BA were 3.333 and 3.739,and p values 0.001 and 0.000 respectively.As to the multiple linear regressions between SPBSI and its influents factors,Sex and FBI were found with significance(P<0.05)in MCA and ICA,while sex,FBI and diabetes mellitus in BA.Conclusions:Spectrum-peak-back-shift(SPBS)is related to atherosclerosis in the detected artery,but it may be influenced by other factors,such as that atheroslerosis may be more severe in the posterior than in the anterior circulation.

关 键 词：经颅多谱勒超怕 股肱指数 动脉硬化 

分 类 号：R445.1[医药卫生—影像医学与核医学]