中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2013年
12期
21-24
,共4页
大脑中动脉%超声检查,多谱勒,经颅%血管狭窄%血管储备功能
大腦中動脈%超聲檢查,多譜勒,經顱%血管狹窄%血管儲備功能
대뇌중동맥%초성검사,다보륵,경로%혈관협착%혈관저비공능
Middle cerebral artery%Ultrasonography,Doppler,transcranial%Artery stenosis%Cerebrovascular reserve capacity
目的 探讨经颅多普勒超声(TCD)联合呼气末二氧化碳分压(PETCO2)评估脑血管狭窄患者脑血管储备(CVR)功能的临床意义.方法 对52例脑血管狭窄患者(分为单血管狭窄组22例和多血管狭窄组30例)和45例健康体检者(对照组)采用TCD联合PETCO2检测,通过吸入自身呼出二氧化碳诱导高碳酸血症,过度换气诱导低碳酸血症的方法测定CVR功能.结果 (1)单血管狭窄组患侧[(3.16±2.73)％/mm Hg,1 mm Hg =0.133 kPa]、多血管狭窄组病变较重侧[(2.41±1.25) ％/mm Hg]和对照组血管扩张储备[(3.75±1.77)％/mm Hg]比较差异有统计学意义(F=3.866,P＜0.05),其中多血管狭窄组病变较重侧的血管扩张储备明显低于对照组,差异有统计学意义(t=-2.657,P＜0.05).单血管狭窄组患侧[(3.13±1.38) ％/mm Hg]、多血管狭窄组病变较重侧[(2.01±1.89)％/mm Hg]和对照组血管整体储备[(3.51±0.92)％/mm Hg]比较差异有统计学意义(F=5.905,P＜ 0.05),其中多血管狭窄组病变较重侧血管整体储备明显低于对照组及单血管狭窄组患侧,差异有统计学意义(t=-3.468、2.582,P＜0.05).(2)单血管狭窄组、多血管狭窄组及对照组在平静呼吸、低碳酸血症、高碳酸血症时PETCO2比较差异均无统计学意义(F=0.398、0.967、1.186,P＞ 0.05).(3)血管病变程度与血管扩张储备、血管整体储备呈负相关(r=-0.433、-0.475,P＜ 0.05).结论 TCD联合PETCO2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.脑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,CVR功能越差.
目的 探討經顱多普勒超聲(TCD)聯閤呼氣末二氧化碳分壓(PETCO2)評估腦血管狹窄患者腦血管儲備(CVR)功能的臨床意義.方法 對52例腦血管狹窄患者(分為單血管狹窄組22例和多血管狹窄組30例)和45例健康體檢者(對照組)採用TCD聯閤PETCO2檢測,通過吸入自身呼齣二氧化碳誘導高碳痠血癥,過度換氣誘導低碳痠血癥的方法測定CVR功能.結果 (1)單血管狹窄組患側[(3.16±2.73)％/mm Hg,1 mm Hg =0.133 kPa]、多血管狹窄組病變較重側[(2.41±1.25) ％/mm Hg]和對照組血管擴張儲備[(3.75±1.77)％/mm Hg]比較差異有統計學意義(F=3.866,P＜0.05),其中多血管狹窄組病變較重側的血管擴張儲備明顯低于對照組,差異有統計學意義(t=-2.657,P＜0.05).單血管狹窄組患側[(3.13±1.38) ％/mm Hg]、多血管狹窄組病變較重側[(2.01±1.89)％/mm Hg]和對照組血管整體儲備[(3.51±0.92)％/mm Hg]比較差異有統計學意義(F=5.905,P＜ 0.05),其中多血管狹窄組病變較重側血管整體儲備明顯低于對照組及單血管狹窄組患側,差異有統計學意義(t=-3.468、2.582,P＜0.05).(2)單血管狹窄組、多血管狹窄組及對照組在平靜呼吸、低碳痠血癥、高碳痠血癥時PETCO2比較差異均無統計學意義(F=0.398、0.967、1.186,P＞ 0.05).(3)血管病變程度與血管擴張儲備、血管整體儲備呈負相關(r=-0.433、-0.475,P＜ 0.05).結論 TCD聯閤PETCO2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.腦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,CVR功能越差.
목적 탐토경로다보륵초성(TCD)연합호기말이양화탄분압(PETCO2)평고뇌혈관협착환자뇌혈관저비(CVR)공능적림상의의.방법 대52례뇌혈관협착환자(분위단혈관협착조22례화다혈관협착조30례)화45례건강체검자(대조조)채용TCD연합PETCO2검측,통과흡입자신호출이양화탄유도고탄산혈증,과도환기유도저탄산혈증적방법측정CVR공능.결과 (1)단혈관협착조환측[(3.16±2.73)％/mm Hg,1 mm Hg =0.133 kPa]、다혈관협착조병변교중측[(2.41±1.25) ％/mm Hg]화대조조혈관확장저비[(3.75±1.77)％/mm Hg]비교차이유통계학의의(F=3.866,P＜0.05),기중다혈관협착조병변교중측적혈관확장저비명현저우대조조,차이유통계학의의(t=-2.657,P＜0.05).단혈관협착조환측[(3.13±1.38) ％/mm Hg]、다혈관협착조병변교중측[(2.01±1.89)％/mm Hg]화대조조혈관정체저비[(3.51±0.92)％/mm Hg]비교차이유통계학의의(F=5.905,P＜ 0.05),기중다혈관협착조병변교중측혈관정체저비명현저우대조조급단혈관협착조환측,차이유통계학의의(t=-3.468、2.582,P＜0.05).(2)단혈관협착조、다혈관협착조급대조조재평정호흡、저탄산혈증、고탄산혈증시PETCO2비교차이균무통계학의의(F=0.398、0.967、1.186,P＞ 0.05).(3)혈관병변정도여혈관확장저비、혈관정체저비정부상관(r=-0.433、-0.475,P＜ 0.05).결론 TCD연합PETCO2작위일충간단、방편、경제적수단가유효지용우CVR공능적평개여연구.뇌혈관병변환자유우혈관협착、폐새、혈류수조사CVR공능강저,협착정도월중,CVR공능월차.
Objective To study the clinical significance of cerebrovascular reserve (CVR) capacity in cerebral vessels stenosis (CVS) patients with transcranial Doppler (TCD) and end-tidal carbon dioxide partial pressure (PETCO2).Methods Fifty-two CVS patients were divided into two groups:one blood vessel stenosis group (22 cases) and multi blood vessels stenosis group (30 cases).Forty-five normal persons were selected as control group.All the groups were routinely examined with TCD and PETCO2.Hypercapnia was induced by inhaling the carbon dioxide who breathed himself,and hypocapnia was induced by voluntary hyperventilation to investigate the CVR capacity.Results (1)The vasodilator reserve of affected side of one blood vessel stenosis group [(3.16 ± 2.73)％/mm Hg,1 mm Hg =0.133 kPa],the heavier side of multi blood vessels stenosis group [(2.41 ± 1.25)％/mm Hg],and control group [(3.75 ± 1.77)％/mm Hg] had significant difference (F =3.866,P ＜ 0.05).The vasodilator reserve of heavier side of multi blood vessels stenosis group was significantly lower than that of control group (t =-2.657,P ＜ 0.05).The overall reserve of affected side of one blood vessel stenosis group [(3.13 ± 1.38)％/mm Hg],the heavier side of multi blood vessels stenosis group [(2.01 ± 1.89)％/mm Hg],and control group [(3.51 ±0.92)％/mm Hg] had significant difference (F =5.905,P ＜ 0.05).The overall reserve of heavier side of multi blood vesse stenosis group was significantly lower than that of control group and affected side of one blood vessels stenosis group (t =-3.468,2.582,P ＜ 0.05).(2) There was no significant difference among the 3 groups in PETCO2 when eupnea,hypocapnia and hypercapnia.(3) The extent of vascular disease correlated negatively with the vasodilator reserve and overall reserve (r =-0.433 and-0.475,P＜0.05).Conclusions TCD and PETCO2 are simple,economic and effective methods for assessing CVR capacity.The CVR capacity is reduced in patients with cerebral vessels changes.
