血液黏滞系数对颅内大型动脉瘤剪切力的影响  

Impact of blood viscosity on wall shear stress of large intracranial aneurysms

作　　者：吴京[1] 刘爱华[1] 赵艺[2] 符策基[2] 彭汤明[1] 钱增辉[1] 康慧斌[1] 吴中学[1] 

机构地区：[1]首都医科大学附属北京天坛医院北京市神经外科研究所,100050 [2]北京大学工学院力学与工程科学系

出　　处：《中华实验外科杂志》2015年第6期1358-1360,共3页Chinese Journal of Experimental Surgery

基　　金：国家自然科学基金资助项目（30901557）;北京市自然科学基金资助项目（7142032）;北京市高层次卫生人才资助项目（2011-3-036）;北京市科技新星计划资助项目（2007A043）

摘　　要：目的 应用血流动力学数值模拟技术分析不同血液黏滞系数对颅内大型动脉瘤剪切力水平的影响.方法 收集我院2013年6月至2013年7月收治的8例颅内大型囊性动脉瘤患者脑血管三维影像数据,其中破裂动脉瘤3例,未破裂动脉瘤5例.应用CFD ICEM软件对动脉瘤三维模型进行网格划分,再进行流体力学数值模拟计算.在血液黏滞系数为0.002、0.004和0.012 Pa·s 3种水平时对颅内大型动脉瘤进行血流动力学数值模拟运算并比较动脉瘤及载瘤动脉剪切力差异.结果 血液黏滞系数升高引起动脉瘤及载瘤动脉血流剪切力明显上升.血液黏滞系数为0.002、0.004和0.012 Pa·s时,相应的动脉瘤剪切力平均值分别为（2.79 ±2.23）、（5.27±3.72）和（11.05±7.56） Pa;载瘤动脉剪切力平均值为（5.61±2.59）、（9.56±3.74）和（22.56±12.41） Pa.在所有患者中,动脉瘤剪切力平均水平均低于载瘤动脉.结论 仅从剪切力对血管内皮细胞的影响作用角度分析,血液黏滞系数的异常上升或下降都可能加重剪切力对动脉瘤壁的损伤,增加颅内大型动脉瘤破裂风险.在进行颅内动脉瘤血流动力学相关研究时,有必要采用患者真实的血液黏滞系数,这样才能获得更加准确的实验结果.Objective To simulate the computational hemodynamics of large intracranial aneurysms and analyze the impact of blood viscosity on wall shear stress.Methods Eight large intracranial aneurysms at internal carotid artery between June 2013 and July 2013 were studied retrospectively.Among them,3 aneurysms were ruptured and 5 were unruptured.Pulsatile CFD simulations were carried out using three levels of blood viscosity （0.002,0.004,0.012 Pa·s）.For each aneurysm model,the average wall shear stress （WSS） predicted by the three blood viscosity levels were compared.Results Blood viscosity has significant impaction on average wall shear stress of intracranial aneurysms and parent artery.Average wall shear stress increased significantly with the increase of blood viscosity.When blood viscosity was 0.002,0.004,0.012 Pa·s,the average wall shear stress of aneurysms was （2.79 ±2.23）,（5.27 ±3.72） and （11.05 ± 7.56） Pa,respectively.The average wall shear stress of parent artery was （5.61 ± 2.59）,（9.56 ± 3.74） and （22.56 ± 12.41） Pa respectively.A reduction in wall shear stress between the parent artery and the aneurysm sac was found in all the cases.Conclusion Abnormal increase or decrease in blood viscosity may aggravate vascular wall damage and increase the risk of aneurysmal rupture.It is necessary to adopt patient-specific value of blood viscosity in future hemodynamic studies of intracranial aneurysms.

关 键 词：血液黏滞性 颅内大型动脉瘤 剪切力 血流动力学 

分 类 号：R743[医药卫生—神经病学与精神病学]