腔隙性脑梗死与小量脑出血患者脑动静脉血流动力学特征分析  

Characteristics of the venous and arterious hemodynamics in patients with lacunar cerebral infarction and small amount cerebral hemorrhage

作　　者：周艳霞[1] 韩漫夫[1] 黄楚明 夏永娣[1] 池枫[1] 龙霞[1] 陈旭彬[1] 

机构地区：[1]深圳市第二人民医院,518035 [2]广东省汕头中心医院,515031

出　　处：《疑难病杂志》2016年第2期111-115,共5页Chinese Journal of Difficult and Complicated Cases

基　　金：广东省科技计划项目(2013B021800107)

摘　　要：目的分析腔隙性脑梗死与小量脑出血患者脑动静脉血流动力学特点。方法选取2014年10月一2015年4月深圳市第二人民医院和汕头中心医院腔隙性脑梗死患者47例(脑梗死组)、脑出血患者12例(脑出血组),以急性起病第3天作为观测时点,采用TCD的2MHz探头分别检测双侧大脑中动脉(MCA)及基底静脉(BVR)的收缩期血流速度(Vs)、舒张期血流速度(Vd)、平均血流速度(Vm)、脉动指数(PI)、阻力指数(砌)以及TCD频谱形态。选择同时期健康体检者85例为健康对照组。结果(1)健康对照组BVR检出率(85.0%)高于脑梗死及脑出血组(67.1%和60.0%)。(2)健康对照组BVR的血流速度女性比男性快,健康对照组及脑梗死组双侧BVR的Vs、Vd、Vm、PI、RI基本对称,差异无统计学意义(P>0.05);2组双侧MCR的Vs、.Vd、Vm基本对称,差异元统计学意义(P>0.05);但脑梗死组的PI、右RI高于健康对照组,差异有统计学意义(P<0.05)。3组男性患者BVR的双侧Vs、PI、RI及右侧Vd、Vm比较差异有统计学意义(P<0.05),脑出血组低于健康对照组和脑梗死组。3组男性MCA的左侧Vd及双侧PI、RI差异均有统计学意义(P<0.05)。结论小量脑出血患者的BVR血流速度较健康者、腔隙性脑梗死患者减慢,腔隙性脑梗死、小量脑出血患者MCA的PI、RI指数增高。Objective To analyze arteriovenous hemodynamic characteristics in patients with cerebral lacunar infarction and small amount cerebral hemorrhage.Methods From October 2014 to April 2015,47 cases of patients with cerebral infarction and 12 cases of cerebral hemorrhage in the Second People＇s Hospital of Shenzhen City and Shantou Center Hospital were enrolled,the third day of acute onset as observation point,using TCD 2MHz probe to detect the systolic flow velocity（Vs） of bilateral middle cerebral artery（MCA） and basal vein（BVR）,the end diastolic velocity（Vd）,mean blood flow velocity（Vm）,pulse index（PI）,and resistance index（RI） and TCD spectrum contour.85 cases（healthy control group）were selected at the same time.Results（1） The detection rate of BVR in healthy control group（85.0%） was higher than that in cerebral infarction and cerebral hemorrhage group（67.1%and 60.0%）.The detection rate of BVR in male was significantly higher than that in female.（2） In healthy control group,BVR velocity of blood flow in women was faster than men,healthy control group and cerebral infarction group＇ s bilateral BVR＇s Vs,Vd,Vm,PI,RI were symmetrical,the difference was not statistically significant（P〉0.05）;2 groups＇ bilateral MCR＇s Vs,Vd,Vm were symmetrical,the difference was not statistically significant（P〉0.05）;but in cerebral infarction group,the PI,right RI were higher than that in the healthy control group,the difference were statistically significant（P〈0.05）.Three groups of male patients＇ BVR bilateral Vs,PI,RI and right Vd,Vm＇s differences have statistical significance（P〈0.05）,and cerebral hemorrhage group were lower than those in the healthy control group and cerebral infarction group.The 3 group MCA＇s left Vd and bilateral PI,RI＇s difference were significant（P〈0.05）.Conclusion The BVR blood flow velocity in patients with cerebral hemorrhage was slow,and the PI and RI index of MCA increased,which may be a manifestation of increased in

关 键 词：腔隙性脑梗死 脑出血 小量 血流动力学 基底静脉 大脑中动脉 

分 类 号：R743.3[医药卫生—神经病学与精神病学]