缺血性脑卒中急性期TCD,EEG,BEAM,CT的对比研究  

Comparative Study of TCD, EEG, BEAM, CT in Acute Ischemic Stroke

作　　者：朱榆红[1] 陈纯[1] 高平[1] 保明芳[1] 李燕[1] 

机构地区：[1]昆明医学院第二附属医院神经内科,昆明650101

出　　处：《昆明医学院学报》2003年第1期20-24,27,共6页Journal of Kunming Medical College

摘　　要：目的 :对缺血性脑卒中急性期TCD动态观察 ,并与EEG ,BEAM ,CT等进行对比研究 ,以探讨TCD对缺血性脑卒中早期诊断、病情判断、治疗指导的价值 .方法 :发病 2 4h内首次发病的单侧MCA供血区缺血性脑卒中患者 2 3例 ,于入院即刻进行神经功能缺损评分及床旁TCD检查 ,在第 2 ,4 ,7d进行复查 ,入院当天进行EEG ,BEAM及CT检查 .门诊健康体检者 30人为对照组 .结果 :入院当天TCD异常率高于EEG ,BEAM及CT .入院当天病侧MCAVm降低 ,病侧ACAVm升高 ,分别与自身健侧及对照组比较差异有显著性(P <0 0 1) .MCA流速不对称指数 (AI)与神经功能缺损评分成正相关 (P <0 0 1) ,与BEAM慢波相对功率值成正相关 (P <0 0 5 ) ,与α波相对功率值成负相关 (P <0 0 1) .动态观察病侧MCAVm逐渐恢复并出现流速增高 ,而病侧ACAVm随之下降 .结论 :在缺血性脑卒中急性期TCD异常率高于BEAM ,EEG及CT ,异常程度与病情严重程度相关 ,动态观察可发现血管再通情况 ,具有较高的早期诊断。Objective: To investigate the value of transcranical Doppler sonography in the diagnosis, assessing seriousness and predicting prognosis in acute ischemic stroke. Methods: 22 consecutive patients with a first acute ischemic stroke involving hemispheric middle cerebral artery (MCA). All patients were evaluated by bedside TCD, computed tomography (CT), electroencephalography (EEG), brain electrical activity mapping (BEAM) and MESSS within 24?hours of symptom onset. The TCD sonography and MESSS score were repeated in 2?nd, 4?th, 7?th day. Results: On first day TCD abnormal rate was 91 3%, higher than EEG (65 2%), beam (78 37%), and CT (17 4) . Mean velocity of middle cerebral artery (MCA V m) of the lesion-side (34 92±13?cm/s) was 113?cm/s, the contra side and the controls( P<0 01), at the same time, mean velocity of anterior cerebral artery (ACA V m) of the lesion-side (65 47±16 69?cm/s) was high contra side and the controls( P<0 01). Asymmetry index (AI) of MCA was negative correlation with MESSS score ( P<0 01). Positive correlation with relative power of slow-wave rang ( P<0 01) and negative correlative with relative power of α-wave rang ( P<0 01). Dynamic study indicated that the ACA V m decreased following MCA V m gradually recovered and velocity increased on the lesion-side . Conclusions: TCD could sensitively detect abnormality correlated with the occluded artery in acute ischemic stroke with higher sensitivity than BEAM, EEG and CT. The abnormality was closely correlated with the seriousness. TCD plays an important role in the early diagnosis, evolution seriousness and therapeutic guidance in acute ischemic stroke.

关 键 词：缺血性脑卒中 经颅多普勒超声 脑电图 脑电地形图 头颅CT 

分 类 号：R743.1[医药卫生—神经病学与精神病学]