症状性大脑中动脉缺血患者脑血管储备能力改变的相关性研究  

Study on relationship between changes of cerebrovascular reserve capacity in patients with symptomatic middle cerebral artery ischemia

作　　者：曾静[1] 刘星辰[1] 杨小燕[1] 王本国[1] 

机构地区：[1]广东省中山市中医院康复科,528400

出　　处：《重庆医学》2014年第20期2582-2583,2586,共3页Chongqing medicine

基　　金：2012年中山市科技局计划项目(20122A053)

摘　　要：目的探讨症状性大脑中动脉(MCA)缺血患者脑血管储备能力(CVR)改变情况及其相关因素。方法将该院经颅多普勒(TCD)和(或)MRI检查发现MCA狭窄的患者80例根据临床表现分为无症状组(n=52)和有症状组(n=28),并选择无脑血管狭窄及卒中危险因素的健康人30例作为对照组。所有受试者行TCD联合屏气试验检测患者CVR,比较脑血管狭窄患者的临床资料,应用单因素和多因素Logistic回归分析。结果有症状组屏气指数(BHI)为0.44±0.14,显著低于无症状组0.75±0.22和对照组0.98±0.27(P<0.05)。有症状组患者吸烟指数、饮酒指数、高血压、高血脂、糖尿病、脑卒中家族史、颈动脉内膜中层厚度(IMT)显著高于无症状组(P<0.05)。经Logistic回归分析显示吸烟、高血压、高血脂、糖尿病、IMT与BHI相关(P<0.05)。结论症状性MCA缺血患者CVR下降,患者CVR改变与吸烟指数、饮酒指数、高血压等脑卒中危险因素相关,CVR降低对脑缺血性事件预测具有一定价值。Objective To investigate the changes of middle cerebral artery（MCA） in patients with ischemic cerebrovascular re-serve capacity（CVR） and its related factors .Methods 80 patients of MCA stenosis diagnosed by transcranial Doppler（TCD） and （or） magnetic resonance imaging（MRI） were divided into asymptomatic group（n=52） and symptom group（n=28） ,and selected 30 healthy people without cerebral vascular stenosis and stroke risk factors as control group .All subjects underwent TCD combined with breath holding test in patients with CVR ,clinical data were compared in patients with cerebrovascular stenosis ,Logistic appli-cation of single factor and multi factor regression were used to analyed the factors affecting CVR .Results The breath holding index （BHI）of symptom group was 0 .44 ± 0 .14 ,significantly lower than that of the asymptomatic group 0 .75 ± 0 .22 and control group 0 .98 ± 0 .27（P〈0 .05） .Patients with smoking index ,symptom group drinking index ,hypertension ,hyperlipidemia ,diabetes ,family history of stroke ,carotid intima-media thickness（IMT） were significantly higher than that in the asymptomatic group（P〈0 .05） . Logistic regression analysis showed that smoking ,hypertension ,hyperlipemia ,diabetes ,IMT were associated with BHI（P〈0 .05） . Conclusion Symptomatic MCA ischemia in patients with decreased CVR ,CVR changes and smoking index in patients with stroke risk index ,drinking ,hypertension and other factors are related to lower CVR ,and has a certain value in cerebral ischemic event pre-diction .

关 键 词：卒中 脑血管储备能力 大脑中动脉缺血 相关因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]