经颅多普勒监测缺血性卒中患者脑动脉微栓子  

Transcranial Doppler Monitoring of Cerebral Arteries foricroemboli in Patients with Ischemic Stroke

作　　者：傅建辉[1] 吕传真[1] 董强[1] 洪震[1] 周华琳[1] 

机构地区：[1]复旦大学附属华山医院神经内科,上海200040

出　　处：《复旦学报（医学版）》2002年第1期39-41,共3页Fudan University Journal of Medical Sciences

摘　　要：目的　了解缺血性卒中患者微栓子的发生率及其可能发病机制。方法　采用德国EMETC 4 0 4 0型经颅多普勒 (TCD)检测仪 ,用soundtrack 2 .4版本的软件对 61例缺血性卒中患者双侧大脑中动脉 (MCA)进行微栓子监测。监测时间不少于 3 0min ,监测前常规行颈动脉B超检查。结果　 6例发现了微栓子 (占 9.83 % ) ,其中 3例为心脏机械瓣膜修复术后患者 ( 1例合并脑栓塞 ,另 2例神经功能正常 ) ,另 3例为非心源性脑梗死患者(占 5 8例非心源性脑梗死患者中 5 .17% )。 3例颅外颈动脉狭窄的患者中 1例微栓子阳性。在非心源性脑梗死患者中 ,仅于患侧MCA处监测到微栓子 ,而在心脏人工瓣膜修复术后患者中 ,双侧MCA均可监测到微栓子。结论　非心源性脑梗死急性期微栓子阳性率低 ,可能与颅外颈动脉狭窄程度有关。Purpose To study the prevalence and mechanism of microemboli in patients with ischemic stroke. Methods Bilateral middle cerebral arteries were detected by transcranial Doppler (EME?TC4040) with a 2?MHz transducer to search for microemboli in 61 patients with acute ischemic stroke.Monitoring time was for no less than 30 minutes. Results Six of the patients (9.83%) showed microemboli during examinations.Among them three were patients with artificial heart valves (one was complicated with cerebral embolism and the other two were normal neurological function);and the other three were patients with noncardiogenic stroke (the prevalence of microemboli was 5.17% in 58 patients with noncardiogenic stroke).In one of the three patients with carotid artery stenosis (≤50%),microemboli was positive.These microemboli occurred ipsilateral to the affected carotid artery in the patients with non cardiogenic stroke,whereas in 2 patients with artificial heart valves,microemboli were observed bilaterally. Conclusions The low prevalence of microemboli in patients with noncardiogenic ischemic stroke may be associated with the severity of carotid stenosis.

关 键 词：经颅多普勒 微栓子 缺血性卒中 脑动脉 

分 类 号：R743.31[医药卫生—神经病学与精神病学]