经颅多普勒超声造影检查在神经内科疾病诊断中的应用价值  

Application value of transcranial doppler contrast-enhanced ultrasound in the diagnosis of neurological diseases

作　　者：李婷 董亮艳 孙广宏[1] 余敏[1] LI Ting;DONG LiangYan;SUN Guanghong;YU Min(Department of Neuroelectrophysiology,People′s Hospital of Ningxia Hui Autonomous Region,Yinchuan 750002,China;Department of Neuroelectrophysiology,Cardio Cerebrovascular Hospital,General Hospital of Ningxia Medical University,Yinchuan 750002,China)

机构地区：[1]宁夏回族自治区人民医院功能科神经电生理室,宁夏银川750002 [2]宁夏医科大学总医院心脑血管病医院神经电生理科,宁夏银川750002

出　　处：《宁夏医学杂志》2021年第4期311-313,I0002,共4页Ningxia Medical Journal

摘　　要：目的通过对神经内科常见疾病患者进行经颅多普勒超声声学造影(c-TCD)检测,探讨c-TCD在神经内科常见症状与右向左分流疾病(RLS)相关性筛查中的应用价值。方法回顾性分析临床表现为偏头痛、晕厥、眩晕、脑梗死、短暂性脑缺血发作(TIA)、视网膜中央动脉阻塞患者2288例,其全部行c-TCD检测,对730例阳性病例进行分析。对照组为68例正常健康人。结果c-TCD总阳性率为31.91%,其中固有型分流占25.07%,潜在型分流占74.93%。各类疾病的阳性率分别为:偏头痛阳性率为35.71%,晕厥阳性率为47.82%,眩晕阳性率为30.75%,脑梗死阳性率为25.09%,TIA阳性率为16.67%,视网膜中央动脉阻塞阳性率为5.56%;对照组的阳性率为17.65%,其中偏头痛、晕厥、眩晕组的阳性率明显高于对照组(P<0.05)。结论神经内科疾病患者如偏头痛、眩晕、晕厥、不明原因脑梗死等与RLS密切相关,RLS也可能是青年视网膜中央动脉阻塞的一个罕见病因,c-TCD为右向左分流疾病的筛查提供了简便、安全、价廉的手段,可对卵圆孔未闭提供治疗依据。Objective To explore the value of contrast-enhanced transcranial Doppler(c-TCD)in screening the correlation between common symptoms and right-to-left shunt disease(RLS)in neurology.Methods 2288 patients with migraine,syncope,vertigo,cerebral infarction,TIA and central retinal artery occlusion and ocular ischemic syndrome were analyzed retrospectively.All of them were detected by C-TCD.730 positive cases were analyzed and the control group consisted of 68 normal healthy cases.Results The total positive rate of c-TCD was 31.91%,of which 25.07%was the intrinsic shunt and 74.93%was the latent shunt.The positive rates of migraine,syncope,vertigo,cerebral infarction,TIA and ocular ischemic syndrome were 35.71%,47.82%,30.75%,25.09%,16.67%and 5.56%,respectively.The positive rate of the control group was 17.65%.The positive rate of migraine,syncope and vertigo group was significantly higher than that of the control group(P<0.05).Conclusion Neurological diseases such as migraine,vertigo,syncope,cerebral infarction of unknown cause are closely related to right-to-left shunt.Right to left shunt may also be a rare cause of ocular ischemic syndrome in young people.C-TCD provides a simple,safe and inexpensive means for screening right-to-left shunt,and it can provides a basis for the treatment of patent foramen ovale.

关 键 词：经颅多普勒超声声学造影 右向左分流疾病 偏头痛 晕厥 眩晕 脑梗死 

分 类 号：R741.04[医药卫生—神经病学与精神病学]