TCD对无症状性颈动脉狭窄患者微栓子检测的临床研究  

Clinical research of transcranial coppler monitoring the microemboli of patients with asymptomatic carotid stenosis

作　　者：刘晓林 张妍 张玉镇 王哲 张辉 王运良 

机构地区：[1]解放军第一四八中心医院神经内科,周村255300 [2]济南军区总医院神经内科,济南250031 [3]烟台山医院神经内科,烟台264001

出　　处：《中国实用神经疾病杂志》2015年第2期43-45,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的应用经颅多普勒(TCD)检查微栓子以识别无症状性(ACS)颈动脉狭窄患者中需要治疗的高危患者。方法收集本院神经内科常规体检人员,经多普勒超声检查发现颈动脉狭窄≥50%,而未发生缺血症状或至少在12个月内无症状者,应用TCD检查微栓子,每月1次,连续随访2a。结果入选213例患者,23例(10.8%)初次检查发现微栓子(TCD+),190例(89.2%)没有发现微栓子(TCD-)。随访1a,TCD+组2例(17.4%)发生卒中,而TCD-组5例(2.6%)发生卒中;2a时TCD+组1例(4.5%)发生卒中,TCD-组3例(1.6%)发生卒中。结论对无症状性颈动脉狭窄患者,TCD检查微栓子阳性者卒中发病率高,应给予药物或相应的手术治疗,预防卒中发生。Objective To investigate the transcranial doppler （TCD） monitoring the microemboli of patients with asymptomatic carotid stenosis. Methods The following persons were examined to monitor the microemboli by TCD once a month, followed up for 2 years： routine medical examination persons, patients with carotid stenosis of ≥ 50% by doppler ultrasound and without ischemia symptomatic or asymptomatic at least 12 months. Results There were 23 cases of patients with microemboll at initial examination （10.8%, TCD-b） and 190 cases of patients without microemboli （89.2 %, TCD-）. Followed up 1 year, there 2 cases of TCD＋patients with stroke and 5 cases of TCD- patients with stroke. Followed up 2 year, there 1 cases of TCD＋ patient with stroke and 3 cases of TCD- patients with stroke. Conclusion Patients with asymptomatic carotid stenosis have higher positive TCD microemboli, which should be treated with medicine and relevant operation therapy to prevent incidence of stroke.

关 键 词：无症状性颈动脉狭窄 经颅多普勒 内膜切除 微栓子 缺血性卒中 

分 类 号：R743.3[医药卫生—神经病学与精神病学]