CAJ | 학술논문

背景:小脑顶核刺激具有调节和扩张血管的功能,可以明显增加局部脑血流,但其作用机制是否通过改善血管内皮功能尚不明确.目的:研究电刺激小脑顶核对老年短暂性脑缺血发作患者血流介导的血管舒张功能的影响,探讨其对短暂性脑缺血发作患者血管的保护作用机制.设计:以患者为研究对象,以诊断为依据的随机对照研究.单位:一所大学医院的综合科、康复室及超声波室联合进行的课题研究.对象:2001-02/2002-10华中科技大学同济医学院附属同济医院综合科住院的年龄＞60岁的44例短暂性脑缺血发作患者,排除既往有脑出血或脑梗死、心房纤颤及其他心律失常或心力衰竭、血液系统疾病患者.随机分为治疗组(22例):小脑顶核刺激+常规治疗;对照组(22例)为常规治疗组.方法:采用高分辨率超声技术和肱动脉充血反应法,检测短暂性脑缺血发作患者治疗前后肱动脉内径变化率.主要观察指标:短暂性脑缺血发作患者治疗前后肱动脉内径变化率.结果:电刺激小脑顶核治疗组治疗前后肱动脉内径变化率由(4.59±3.32)%增至(10.34±3.13)%,治疗前后比较差异有显著性意义(t=5.91,P＜0.01),对照组治疗前后肱动脉内径变化率由(4.68±3.20)%增至(5.10±3.29)%,差异无显著性意义(t=1.72,P＞0.05),治疗后电刺激小脑顶核治疗组与对照组比较,差异有显著性意义(t=5.41,P＜0.01).结论:电刺激小脑顶核治疗后肱动脉内径反应性血管充血功能明显改善,电刺激小脑顶核能明显改善老年短暂性脑缺血患者的血管内皮功能.
배경:소뇌정핵자격구유조절화확장혈관적공능,가이명현증가국부뇌혈류,단기작용궤제시부통과개선혈관내피공능상불명학.목적:연구전자격소뇌정핵대노년단잠성뇌결혈발작환자혈류개도적혈관서장공능적영향,탐토기대단잠성뇌결혈발작환자혈관적보호작용궤제.설계:이환자위연구대상,이진단위의거적수궤대조연구.단위:일소대학의원적종합과、강복실급초성파실연합진행적과제연구.대상:2001-02/2002-10화중과기대학동제의학원부속동제의원종합과주원적년령＞60세적44례단잠성뇌결혈발작환자,배제기왕유뇌출혈혹뇌경사、심방섬전급기타심률실상혹심력쇠갈、혈액계통질병환자.수궤분위치료조(22례):소뇌정핵자격+상규치료;대조조(22례)위상규치료조.방법:채용고분변솔초성기술화굉동맥충혈반응법,검측단잠성뇌결혈발작환자치료전후굉동맥내경변화솔.주요관찰지표:단잠성뇌결혈발작환자치료전후굉동맥내경변화솔.결과:전자격소뇌정핵치료조치료전후굉동맥내경변화솔유(4.59±3.32)%증지(10.34±3.13)%,치료전후비교차이유현저성의의(t=5.91,P＜0.01),대조조치료전후굉동맥내경변화솔유(4.68±3.20)%증지(5.10±3.29)%,차이무현저성의의(t=1.72,P＞0.05),치료후전자격소뇌정핵치료조여대조조비교,차이유현저성의의(t=5.41,P＜0.01).결론:전자격소뇌정핵치료후굉동맥내경반응성혈관충혈공능명현개선,전자격소뇌정핵능명현개선노년단잠성뇌결혈환자적혈관내피공능.
BACKGROUND: Stimulating cerebellar fastigial nucleus can regulate, dilate blood vessels and greatly increase local blood flow. However, if its mechanism is to improve the function of vascular endothelium is still uncertain.OBJECTIVE: To study the effects of stimulating cerebellar fastigial nucleus by electricity to vascular relaxation of transient ischemic attack(TIA) patients which is induced by blood flow and explore its protective mechanism to blood vessels of TIA patients.DESIGN: Randomized case control study to patients based on diagnosis SETTING: Department of general diseases, rehabilitation room and ultrasound department of a university hospital.PARTICIPANTS: Forty-four TIA patients(＞ 60 years old) admitted into Department of General Diseases of Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology during February 2001 to October 2002 were selected after excluding cerebral hemorrhage or cerebral infarction, atrium fibrillation and other arrhythmia or heart failure and blood system diseases. They were randomly divided into treatmentgroup(22 cases)and control group(22 cases) which were conducted stimulating fastigial nucleus + routine treatment and only routine treatment respectively.METHODS: High resolution ultrasound technique and brachial artery congestion method were used to test the internal diameter change rate of brachial artery in TIA patients before and after treatment.MAIN OUTCOME MEASURES: The internal diameter change rate of brachial artery of TIA pat ients.RESULTS: The internal diameter change rate of brachial artery was (4.59 ± 3.32) % and ( 10. 34 ± 3.13 ) % respectively before and after conducting electric stimulus to fastigial nucleus with significant difference ( t = 5.91, P ＜ 0.01 ). There was significant difference on internal diameter change rate between treatment group and control group( t =5.41, P ＜ 0.01 )while there was no difference in control group before and after treatment [(4.68±3.20) %,(5.10±3.29) %](t=1.72, P＞ 0.05).CONCLUSION: Conducting electric stimulating to fatigial nucleus can greatly improve the reactively vascular congestive function of brachial artery internal diameter and it can improve the vascular endothelial functions of TIA patients.