椎动脉狭窄及介入治疗的血流动力学分析  

Hemodynamics analysis on vertebral artery stenosis and interventional therapy

作　　者：彭红梅[1] 张东威[2] 李敏[2] 

机构地区：[1]内蒙古民族大学物理与电子信息学院计算物理研究所,内蒙古通辽028000 [2]内蒙古民族大学附属医院神经内科,内蒙古通辽028043

出　　处：《生物医学工程与临床》2015年第4期345-349,共5页Biomedical Engineering and Clinical Medicine

基　　金：国家自然科学基金资助项目(11362015);内蒙古自治区自然科学基金资助项目(2013MS0113)

摘　　要：目的研究椎动脉狭窄及介入治疗后血流动力学状态的变化。方法数字减影血管造影(DSA)可为介入治疗提供直接的影像依据,以内蒙古民族大学附属医院1例椎动脉狭窄患者的DSA病例资料为例,利用计算流体力学(CFD)软件FLUENT 6.2.16,在一个心动周期(T)内对椎动脉狭窄介入治疗前后局部血管血流动力学变化情况进行了分析,重点讨论了椎动脉狭窄存在时,t1=0.05T、t2=0.12T、t3=0.21T时刻血液流场状况,比较t3(血流速度峰值)时刻介入治疗前后血液流场及血管壁切应力变化。结果血流速度较小时(t1、t2时刻),由于起始端狭窄存在,椎动脉中血流量不足,影响大脑供血。血流速度较大时(t3时刻),椎动脉入口处血液出现了严重紊流,同样影响大脑供血,并且狭窄处血管壁较大的切应力可能会撕裂血管内膜,加重增生。椎动脉实施支架植入术后,显著改善椎动脉对大脑的供血情况,同时也改善血管壁的应力状况,起到保护血管的作用。结论对椎动脉狭窄的早期诊断和积极有效治疗可以降低卒中发病率。Objective To study the changes of hemodynamics characteristics on vertebral artery stenosis and the effect of interventional therapy. Methods Digital subtraction angiography（DSA） was applied for interventional therapy, and DSA images of one patient with vertebral artery stenosis were used as the example. The hemodynamics characteristics of vertebral artery stenosis and the effect of interventional therapy in a cardiac cycles （ T） were analyzed by computational fluid dynamic （CFD） software FLUENT 6.2.16, and the blood flow fields of artery stenosis was studied at t1=0.05T, t2=0.12T, t3=0.21T. The changes of blood flow fields and stress on vessel wall at t3（peak velocity） before and after interventional therapy were compared. Results At lower blood flow velocity（at t1, t2 time）, blood supply was affected by artery stenosis and turbulent flow. When blood flow velocity was higher at t3, it showed that blood supply to vertebral artery was affected by severe blood turbulence, and the vascular wall were torn by shear stress at stenosis and aggravated lesion. The hemodynamic characteristics were improved and the blood vessels were protected after interventional therapy. Conclusion It is demonstrated that the incidence of stroke could be decreased by early diagnosis and performing of active and effective treatment for vertebral artery stenosis.

关 键 词：脑卒中 椎动脉狭窄 数字减影血管造影(DSA) 血流动力学 计算流体力学 

分 类 号：R743[医药卫生—神经病学与精神病学]