经颅多普勒超声结合呼气末二氧化碳分压在脑血管狭窄患者脑血管储备功能评估中的应用研究  

Application of transcranial Doppler combined with PETCO2in evaluation of cerebrovascular reserve in patients with cerebrovascular stenosis

作　　者：李淞[1] 贾小影[1] 李丽[1] 张馨[1] LI Song;JIA Xiao-ying;LI Li(Department of Neurology,Jilin Province People＇s Hospital,Changchun,Jilin 130021,China)

机构地区：[1]吉林省人民医院神经内科,吉林长春130021

出　　处：《中华全科医学》2018年第11期1787-1789,1846,共4页Chinese Journal of General Practice

基　　金：吉林省科技厅重点科技攻关项目(20150204094SF)

摘　　要：目的分析经颅多普勒超声结合呼气末二氧化碳分压在评估脑血管狭窄患者脑血管储备功能的应用价值。方法将2014年1月—2016年6月吉林省人民医院收治的78例脑血管狭窄患者根据血管病变分为单血管狭窄组32例与多血管狭窄组46例,选择45例正常体检健康人群为对照组,均采用经颅多普勒超声结合呼气末二氧化碳分压评估脑血管储备功能。结果对照组、单血管狭窄组(患侧)、多血管狭窄组(轻侧、重侧)血管扩张储备值、血管整体储备值比较差异无统计学意义(均P> 0. 05)。但多血管狭窄组较重侧患者血管收缩储备值明显低于对照组(t=2. 417,P <0. 05);单血管狭窄组、多血管狭窄病变较轻侧组、多血管狭窄病变较重侧组血管扩张储备值、血管整体储备值均明显低于对照组(均P <0. 05);多血管狭窄组病变较重患者血管扩张储备值、血管整体储备值均明显低于单独血管患侧组(P <0. 05);对照组、单血管狭窄组、多血管狭窄组平静呼吸、低碳酸血症、高碳酸血症时呼气末二氧化碳分压比较差异均无统计学意义(均P> 0. 05);脑血管病变程度与血管扩张储备、整体储备呈负相关(均P <0. 05),与血管收缩储备无相关性(P> 0. 05)。结论经颅多普勒超声结合呼气末二氧化碳分压是一种评估脑血管储备功能的有效方法,随着脑血管狭窄病变程度增加,脑血管储备功能明显降低,诱发脑卒中风险增加。Objective To discuss the value of transcranial Doppler （TCD） combined with PET CO2 in the evaluation of cerebrovascular reserve in patients with cerebrovascular stenosis. Methods Total 78 patients with cerebrovascular stenosis were divided into single vascular stenosis group （32 cases） and muhiple vascular stenosis group （46 cases）, and 45 normal health patients were assigned into the control group. TCD combined with PETCO2 were used to evaluate the cerebrovascular reserve function. Results There was no statistically significant difference in the vasodilation reserve and the total blood vessel reserve among the three groups （ both the light side and the heavy side）, all P 〉 0.05. The systolic reserve of vasorelaxation in serious side was significantly lower in the muhivessel stenosis group than that in the control group （t = 2. 417, P 〈 0.05）. The vascular dilation reserve value and vascularity in the single vessel stenosis group were obviously lower than those in the multi-vessel stenosis group （ all P 〈 0.05 ）. There was no significant difference in the PETCO2 during terms of quiet breathing, hypoeapnia, and hypercapnia among the three groups （all P 〉 0.05 ）. The se- verity of cerebral vascular disease was negatively correlated to the vascular expansion reserve value and the overall blood vessel reserve value （ all P 〈 0.05 ）, and no correlation with vascular contraction reserve （ P 〉 0.05 ）. Conclusion TCD combined with PET CO2 is a kind of effective method to evaluate cerebrovascular reserve function. With the increase of severity of cerebral vascular stenosis, cerebral vascular reserve might significantly decrease, which will result in the alteration of risk of stroke.

关 键 词：脑血管狭窄 多普勒超声 呼气末二氧化碳分压 脑血管储备功能 

分 类 号：R743[医药卫生—神经病学与精神病学] R741.04[医药卫生—临床医学]