TCD检测颈内动脉颅外段重度狭窄颅内动脉血流动力学参数的价值  

Value of TCD in detecting hemodynamic parameters of intracranial artery in patients with severe extracranial stenosis of internal carotid artery

作　　者：肖海萍 刘慧玲[1] 黄明 黄开发[1] 何巧媛 XIAO Haiping;LIU Huiling;HUANG Ming;HUANG Kaifa;HE Qiaoyuan(Hubei Hospital of Integrated Traditional and Western Medicine/Xinhua Hospital of Hubei Province,Wuhan 430010,China)

机构地区：[1]湖北省中西医结合医院湖北省新华医院,湖北武汉430010

出　　处：《中国实用神经疾病杂志》2023年第10期1244-1248,共5页Chinese Journal of Practical Nervous Diseases

基　　金：湖北省中西医结合医院“杏林人才工程”院级科研专项(重点项目)(编号:H2023Z001)。

摘　　要：目的探讨经颅多普勒超声(TCD)对颈内动脉颅外段(EICA)重度狭窄中颅内动脉血流动力学参数的检测价值。方法选取2018-05—2023-01湖北省中西医结合医院收治的63例EICA狭窄患者为研究对象,根据临床表现及检查结果分为症状组(n=34)、无症状组(n=29)。所有研究对象均接受TCD诊断,对比2组患者EICA狭窄情况,对比不同狭窄程度患者的MCA血流动力学参数,以及重度无症状、症状患者MCA血流动力学参数,对比症状组、无症状组侧支循环开放情况。结果症状组、无症状组患者EICA狭窄分布情况对比差异有统计学意义(P<0.05),症状组重度EICA狭窄发生率高于无症状组。不同狭窄程度患者大脑中动脉(MCA)血流动力学参数对比差异有统计学意义(P<0.05)。重度狭窄症状组患者MCA的收缩期峰时血流速度(PSV)、舒张末期血流速度(EDV)、平均血流速度(Vm)、搏动指数(PI)均低于重度狭窄无症状组(P<0.05)。TCD显示,2组轻度、中度狭窄患者均未见侧支循环开放事件,而重度无症状组前交通动脉(ACoA)、后交通动脉(PCoA)侧支循环开放率均高于重度症状组(P<0.05),而眼动脉(OA)侧支循环开放率对比差异无统计学意义(P>0.05)。结论TCD可精准监测EICA狭窄患者的颅内动脉血流动力学参数变化,评估EICA狭窄病情进展及颅内侧支循环建立情况,为临床诊治提供可靠依据。Objective To explore the value of transcranial Doppler(TCD)in detecting the changes of in⁃tracranial artery hemodynamics parameters in severe extracranial internal carotid artery(EICA)stenosis.Methods Totally 63 patients with EICA stenosis admitted to the Hubei Hospital of Integrated Traditional and Western Medicine from May 2018 to January 2023 were selected as the study subjects.They were divided into symptomatic group(n=34)and asymptomatic group(n=29)based on clinical manifestations and examination results.All study subjects received TCD diagnosis and the EICA stenosis status was compared between the two groups.The hemodynamic parameters of MCA in patients with different degrees of stenosis,and the hemodynamic parameters of MCA in severe asymptomatic and symptomatic patients,and the opening of collateral circulation between the symptomatic and asymptomatic groups were compared.Results There was a statistically significant difference in the distribution of EICA stenosis between the symptomatic and asymptomatic groups(P<0.05).The incidence of severe EICA stenosis in the symptomatic group was higher than that in the asymptomatic group.There was a statis⁃tically significant difference on the hemodynamic parameters of the middle cerebral artery(MCA)among patients with different degrees of stenosis(P<0.05).The peak systolic velocity(PSV),end diastolic velocity(EDV),mean blood flow velocity(Vm),and pulsatility index(PI)of MCA in patients with severe stenosis symptoms were lower than those on the asymptomatic group with severe stenosis(P<0.05).The TCD results showed that no collateral circulation opening events were observed in both mild and moderate stenosis groups,while the opening rates of the anterior communicating artery(ACoA)and posterior communicating artery(PCoA)collateral circulation in the severe asymptomatic group were higher than those in the severe symptom group(P<0.05),while there was no statistically significant difference on the opening rates of the ophthalmic artery(OA)collateral circulation(P>0.0

关 键 词：颈内动脉颅外段狭窄 颈内动脉狭窄 经颅多普勒超声 血流动力学 侧支循环 

分 类 号：R543.5[医药卫生—心血管疾病]