TCD结合呼吸试验评价颈动脉支架成形术对脑血管反应性的影响  

The changes of cerebral vascular reactivity using transcranial doppler combined with breath test in the patients after carotid angioplasty and stenting

作　　者：陈世文[1] 谭凯如 刘冬英[1] 李超英[1] 黄焕章[1] 

机构地区：[1]广东省江门市中心医院神经内科,广东江门529030

出　　处：《吉林医学》2016年第1期37-39,共3页Jilin Medical Journal

基　　金：江门市卫计局2015年科研立项项目[项目编号:15A001]

摘　　要：目的:通过TCD结合呼吸试验(过度换气试验和屏气呼吸试验)探讨颈动脉支架术对脑血管反应性的影响。方法:以收治的颈动脉狭窄患者45例为研究对象,随机分为手术组和对照组。其中手术组患者25例,使用血管内支架植入手术,对照组患者20例,使用常规药物治疗。分别在入院时和术后2周,通过TCD结合呼吸试验(过度换气诱发低碳酸血症和屏气试验诱发高碳酸血症)的方法测定脑血管反应性,比较两组之间的差异。结果:两种呼吸试验均显示,手术组与对照组相比,术后2周脑血管反应性升高更加明显,差异有统计学意义。结论:与常规药物治疗组相比,颈内动脉支架术能更好改善颈动脉狭窄患者脑血管反应性,TCD结合呼吸试验可作为评估脑血管反应性的简便手段之一。Objective To study the changes of cerebral vascular reactivity using transcranial doppler combined with breath test in the patients after carotid angioplasty and stenting. Method A total of 45 patients with carotid artery stenosis were selected as the clinical study subjects and randomly divided into the surgical group and the control group. The surgical group （25 patients） received endovascular stent- ing while ihe control group （20 patients） received conventional drug therapy. Transcranial doppler combines with breath test （ Hyperventila- tion test can induce hypocapnia and breath holding test induces hypercapnia） were used to evaluate the patients＇ cerebral vascular reactivity on admission and two weekes after operation. Results The cerebrovascular reactivity score in the surgical group increased better than in the control group two weekes after operation;with statistically significant differences. Conclusion Compared to conventional drug therapy, endovascular stenting can improve the cerebrovascular reactivity of carotid artery stenosis patients more effectively. TCD combines with breath test could be used as an easy way for the evaluation of cerebrovascular reactivity.

关 键 词：颈动脉支架形成术 脑血管反应性 过度换气试验 屏气试验 经颅多普勒 

分 类 号：R743.3[医药卫生—神经病学与精神病学]