中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2011年
4期
234-237
,共4页
贾艳红%李月春%张京芬%刘国荣%王宝军%田丽川
賈豔紅%李月春%張京芬%劉國榮%王寶軍%田麗川
가염홍%리월춘%장경분%류국영%왕보군%전려천
大脑中动脉%缩窄,病理性%超声检查,多普勒,经颅%二氧化碳%血气分析
大腦中動脈%縮窄,病理性%超聲檢查,多普勒,經顱%二氧化碳%血氣分析
대뇌중동맥%축착,병이성%초성검사,다보륵,경로%이양화탄%혈기분석
Middle cerebral artery%Constriction,pathologic%Ultrasonography,doppler,transcranial%Carbon Dioxide%Blood gas analysis
目的 探讨采用经颅多普勒超声(TCD)结合呼气末二氧化碳分压(ETCO2)的方法 评价颅内血管狭窄患者脑血管储备(CVR)功能,包括脑血管扩张储备、收缩储备和整体储备功能.方法 对病例组(42例)和健康对照组(30名)进行CVR功能的检查,病例组均经TCD和(或)DSA检查发现一侧或双侧大脑中动脉(MCA)狭窄,并合并其他颅内、外大动脉狭窄患者.受试者均采用DWL公司生产的Multi-Dop*4经颅多普勒超声检测仪,运用DWL公司开发的QL软件,通过外接CO2监测设备监测ETCO2.采用吸入自身CO2气体诱导高碳酸血症,过度换气诱导低碳酸血症的方法 来测定CVR功能.结果 (1)一侧MCA狭窄组的患侧[(3.65%±2.62%)/mm Hg(1 mm Hg=0.133 kPa)]、多血管狭窄组病变较重侧[(1.99%±2.78%)/mm Hg]、对照组的扩张储备值[左侧(3.54%±1.66%)/mm Hg;右侧(3.81%±1.63%)/mm Hg]之间的差异具有统计学意义(F=3.755,P＜0.05),多血管狭窄组病变较重侧的扩张储备值明显低于对照组(t=-2.546,P＜0.05);(2)一侧MCA狭窄组的患侧[(3.22%±1.27%)/mm Hg]、多血管狭窄组病变较重侧[(2.30%±1.14%)/mm Hg]、对照组[左侧(3.19%±0.81%)/mm Hg;右侧(3.23%±0.70%)/mm Hg]的整体储备值之间的差异具有统计学意义(F=5.894,P＜0.01),多血管狭窄组病变较重侧整体储备值明显低于对照组(t=-3.357,P＜0.01);多血管狭窄组病变较重侧整体储备值低于一侧中动脉狭窄组的患侧(t=2.471,P＜0.05);(3)血管病变程度与病变较重侧的脑血管扩张储备值、整体储备值之间呈负相关,相关系数分别为r=-0.322,P＜0.05;r=-0.364,P＜0.05.结论 TCD结合ETCO2作为一种简单、方便、经济的手段可有效地用于CVR功能的评价与研究.颅内血管病变患者由于血管狭窄、闭塞、血流受阻使CVR功能降低,狭窄程度越重,脑血管的储备能力越差.
目的 探討採用經顱多普勒超聲(TCD)結閤呼氣末二氧化碳分壓(ETCO2)的方法 評價顱內血管狹窄患者腦血管儲備(CVR)功能,包括腦血管擴張儲備、收縮儲備和整體儲備功能.方法 對病例組(42例)和健康對照組(30名)進行CVR功能的檢查,病例組均經TCD和(或)DSA檢查髮現一側或雙側大腦中動脈(MCA)狹窄,併閤併其他顱內、外大動脈狹窄患者.受試者均採用DWL公司生產的Multi-Dop*4經顱多普勒超聲檢測儀,運用DWL公司開髮的QL軟件,通過外接CO2鑑測設備鑑測ETCO2.採用吸入自身CO2氣體誘導高碳痠血癥,過度換氣誘導低碳痠血癥的方法 來測定CVR功能.結果 (1)一側MCA狹窄組的患側[(3.65%±2.62%)/mm Hg(1 mm Hg=0.133 kPa)]、多血管狹窄組病變較重側[(1.99%±2.78%)/mm Hg]、對照組的擴張儲備值[左側(3.54%±1.66%)/mm Hg;右側(3.81%±1.63%)/mm Hg]之間的差異具有統計學意義(F=3.755,P＜0.05),多血管狹窄組病變較重側的擴張儲備值明顯低于對照組(t=-2.546,P＜0.05);(2)一側MCA狹窄組的患側[(3.22%±1.27%)/mm Hg]、多血管狹窄組病變較重側[(2.30%±1.14%)/mm Hg]、對照組[左側(3.19%±0.81%)/mm Hg;右側(3.23%±0.70%)/mm Hg]的整體儲備值之間的差異具有統計學意義(F=5.894,P＜0.01),多血管狹窄組病變較重側整體儲備值明顯低于對照組(t=-3.357,P＜0.01);多血管狹窄組病變較重側整體儲備值低于一側中動脈狹窄組的患側(t=2.471,P＜0.05);(3)血管病變程度與病變較重側的腦血管擴張儲備值、整體儲備值之間呈負相關,相關繫數分彆為r=-0.322,P＜0.05;r=-0.364,P＜0.05.結論 TCD結閤ETCO2作為一種簡單、方便、經濟的手段可有效地用于CVR功能的評價與研究.顱內血管病變患者由于血管狹窄、閉塞、血流受阻使CVR功能降低,狹窄程度越重,腦血管的儲備能力越差.
목적 탐토채용경로다보륵초성(TCD)결합호기말이양화탄분압(ETCO2)적방법 평개로내혈관협착환자뇌혈관저비(CVR)공능,포괄뇌혈관확장저비、수축저비화정체저비공능.방법 대병례조(42례)화건강대조조(30명)진행CVR공능적검사,병례조균경TCD화(혹)DSA검사발현일측혹쌍측대뇌중동맥(MCA)협착,병합병기타로내、외대동맥협착환자.수시자균채용DWL공사생산적Multi-Dop*4경로다보륵초성검측의,운용DWL공사개발적QL연건,통과외접CO2감측설비감측ETCO2.채용흡입자신CO2기체유도고탄산혈증,과도환기유도저탄산혈증적방법 래측정CVR공능.결과 (1)일측MCA협착조적환측[(3.65%±2.62%)/mm Hg(1 mm Hg=0.133 kPa)]、다혈관협착조병변교중측[(1.99%±2.78%)/mm Hg]、대조조적확장저비치[좌측(3.54%±1.66%)/mm Hg;우측(3.81%±1.63%)/mm Hg]지간적차이구유통계학의의(F=3.755,P＜0.05),다혈관협착조병변교중측적확장저비치명현저우대조조(t=-2.546,P＜0.05);(2)일측MCA협착조적환측[(3.22%±1.27%)/mm Hg]、다혈관협착조병변교중측[(2.30%±1.14%)/mm Hg]、대조조[좌측(3.19%±0.81%)/mm Hg;우측(3.23%±0.70%)/mm Hg]적정체저비치지간적차이구유통계학의의(F=5.894,P＜0.01),다혈관협착조병변교중측정체저비치명현저우대조조(t=-3.357,P＜0.01);다혈관협착조병변교중측정체저비치저우일측중동맥협착조적환측(t=2.471,P＜0.05);(3)혈관병변정도여병변교중측적뇌혈관확장저비치、정체저비치지간정부상관,상관계수분별위r=-0.322,P＜0.05;r=-0.364,P＜0.05.결론 TCD결합ETCO2작위일충간단、방편、경제적수단가유효지용우CVR공능적평개여연구.로내혈관병변환자유우혈관협착、폐새、혈류수조사CVR공능강저,협착정도월중,뇌혈관적저비능력월차.
Objective The method transcranial Doppler (TCD)and end-tidal carbon dioxide partial pressure (ETCO2 ) was used to investigate the cerebrovascular reserve capacity in patients with intracranial artery stenosis.Including the cerebral vasodilator reserve,contracted reserve and the overall reserve.Methods The 72 cases were enrolled in this study,include of 42 patients with one or two sides middle cerebral artery (MCA) stenosis,or other intracranial artery stenosis and 30 normal persons. All the patients were routinely examined with TCD,and the TCD QL software was used to evaluate the cerebrovascular reserve. Hypercapnia was induced by inhaling the CO2 who breathed himself,and hypocapnia was induced by voluntary hyperventilation. The changes of velocities were recorded in both side of MCA,and the ETCO2 was recorded by the external measuring device. Results ( 1 ) The cerebral vasodilator reserve of one side of MCA stenosis group ( ( 3.65% ± 2. 62% )/mm Hg),the heavier side of multi-vessel stenosis group ( ( 1.99% ± 2. 78% )/mm Hg ),and normal control group ( left ( 3.54% ± 1.66% )/ mm Hg; right (3. 81% ± 1.63% )/mm Hg) had significant difference( F = 3. 755 ,P ＜ 0. 05 ). The heavier side of multivessel stenosis group' s cerebral vasodilator reserve were significantly lower than normal control group ( t =- 2. 546,P ＜ 0. 05 ). (2) The overall reserve of one side of MCA stenosis group ( ( 3.22% ± 1. 27% )/mm Hg),the heavier side of multi-vessel stenosis group( (2. 30% ± 1.14% )/mm Hg),and normal control group(left (3. 19% ±0. 81% )/mm Hg;right (3. 23% ±0. 70% )/mm Hg)had significant difference(F=5. 894,P ＜0. 01 ). The heavier side of multi-vessel stenosis group' s overall reserve were significantly lower than normal control group( t = - 3. 357,P ＜ 0. 01 ) and they were also significantly lower than one side of MCA stenosis group (t = 2.471,P ＜ 0. 05 ). (3) The extent of vascular disease correlated inveresely to the cerebral vasodilator reserve( r = - 0. 322,P ＜ 0. 05 ) and the overall reserve( r = - 0. 364,P ＜ 0. 05 ) in the heavier side of patients who have vascular disease.Conclusions ( 1 ) TCD with ETCO2 is a simple,economic and effective method for assessing CVR. (2)The capacity of cerebrovascular reserve was reduced in patients with intracranial artery stenosis.
