《中国康复理论与实践》 ›› 2006, Vol. 12 ›› Issue (09): 797-799.

• 临床研究 • 上一篇    下一篇

经颅彩色多普勒在大脑中动脉狭窄经皮血管成型并支架植入术前后的应用价值

王磊1,2; 谭莹1; 王华1; 郑虎1   

  1. 1.郧阳医学院附属太和医院神经内科,湖北十堰市 442000;2.武汉大学医学院,湖北武汉市 430071
  • 收稿日期:2006-06-15 出版日期:2006-09-01 发布日期:2006-09-01

Transcranial Doppler as Assessment pre-and post-Pecutaneous Transtuminl Angioplasty and Stenting in Patients with Stenosis of the Middle Cerebral Artery

WANG Lei, TAN Ying, WANG Hua, et al   

  1. Department of Neurology, Taihe Hospital of Yunyang Medical College, Shiyan 442000, Hubei, China
  • Received:2006-06-15 Published:2006-09-01 Online:2006-09-01

摘要: 目的评价经颅彩色多普勒(TCD)在大脑中动脉狭窄经皮血管成型并支架植入术前后的应用价值。方法47例临床表现为反复发作一过性脑缺血(TIA)或脑梗死患者,TCD及数字减影血管造影(DSA)诊断为大脑中动脉狭窄,行血管成型并支架植入术(PTAS),对狭窄血管经PTAS治疗前后形态学及大脑中动脉血流动力学各项指标(平均流速Vm、收缩峰流速Vs、舒张峰流速Vd、脉动指数Pi、阻力指数Ri)进行分析和比较,并与DSA进行比较。结果41例与术前比Vs、Vm、Vd下降,Pi值增高,Ri值变化不大,TCD及DSA随访所有例患者无再发狭窄;5例患者出现Vs、Vm、Vd增快,Pi值增高,但均未见反流信号;1例出现Vs增快,Vm增快,Vd降低。中、重度狭窄TCD与DSA相符率分别为75%、83%。结论TCD能为血管内支架术治疗大脑中动脉狭窄前后疗效提供客观依据,其无创、便捷、廉价的优点,更有优势作为PTAS治疗中、重度MCA狭窄的初选、疗效评价和术后随访的评定方法。

关键词: 经颅彩色多普勒(TCD), 数字减影脑血管造影(DSA), 大脑中动脉狭窄, 经皮血管成型并支架植入术(PTAS)

Abstract: ObjectiveTo evaluate the value of transcranial Doppler (TCD) in pecutaneous transtuminl angioplasty and stenting (PTAS).MethodsThe index of hemodynamics, include mean peak flow velocity (Vm), systolic peak flow velocity (Vs), enddiastolic peak flow velocity (Vd), pulsatility index (Pi), resistance index (Ri) in 47 cases with the stenosis of the middle cerebral artery were investigated, while compared with that of intra arterial digital subtraction angiography (DSA). ResultsVs and Vm of 41 cases increased while the Pi reduced after operation, Ri had no change; Vs, Vm, Vd increased and Pi reduced with no reflow signal in 5 cases. Vs and Vm increased with Vd reduced in only 1 case. The accuracy rate with DSA in moderate or severe stenosis was 75% or 83% respectively. ConclusionTCD, as it's reliable, no-invasive, convenience and cheap, can play an important role in assessing the effect of PTAS in middle cerebral artery stenosis.

Key words: transcranial Doppler, digital subtraction angiography (DSA), middle cerebral artery stenosis, pecutaneous transtuminl angioplasty and stenting (PTAS)