摘要
目的用彩色多普勒超声观察老年脑卒中患者颈动脉形态、结构和血流动力学的改变。方法应用５ＭＨｚ线阵探头彩色多普勒血流显像仪观察５３例脑卒中患者和５９例健康老年人两侧颈动脉内中膜厚度、斑块情况，两侧颈总动脉截面积、平均流速和血流量以及血流动力学改变。结果（ｌ）脑卒中组两侧颈动脉内中膜厚度较对照组明显增厚，出现斑块４１例，占７７％，而对照组无１例出现斑块；（２）脑卒中组两侧颈总动脉平均流速较对照组明显减低，颈总动脉管腔截面积较对照组明显扩大，两组脑血流量改变不明显；（３）脉冲多普勒血流频谱显示脑卒中组收缩期峰值流速值和舒张末流速值均明显小于对照组，收缩一峰与收缩二峰比值两组均大于经验诊断阈值１．０５，反映外周阻力的指标搏动指数（ＰＩ）和阻力指数（ＲＩ）脑卒中组明显高于对照组。结论老年脑卒中患者颈动脉粥样硬化程度明显加重，由于代偿机制而保持了一定的脑血流量，其颈动脉血流速度降低而外周阻力增高。
Objective To study the morphology, structure and hemodynamics of carotid artery with color Doppler flow imaging in aged patients with stroke. Methods A noninvasive method based on high-resolution color Doppler flow imaging was used for quantification of intima-media thickness, identification of plaque and determination of blood flow velocity in the carotid artery. Fifty-three aged patients with stroke and 59 aged healthy subjects were imaged. Results (1)Mean intima-media thickness was 0.13 cm in aged patients with stroke and 0.08 cm in aged healthy subjects. There were 41 patients with plaque in the bifurcation of the carotid artery and none in the aged healthy subjects. (2)Mean velocity was significantly reduced in aged patients with stroke, whereas volume flow did not differ in the two groups. In order to maintain the cerebral blood flow, the lumen of the common carotid artery was significantly dilated. (3)Systolic and diastolic blood flow velocities were significantly reduced in the carotid artery of aged patients with stroke as compared with aged healthy subjects. The pulsatility index and resistive index, the possible indicators of vascular resistance in the cerebral circulation were significantly higher in aged patients with stroke as compared with aged healthy control subjects. Conclusions These results suggest that severe atherosclerosis was found in aged patients with stroke. The mean velocity of blood flow was reduced and the lumen of the common carotid artery was significantly dilated in aged patients with stroke, whereas cerebral volume flow did not differ in the two groups. Hemodynamic parameters were decreased in the aged patients with stroke.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
1996年第2期101-104,共4页
Chinese Journal of Geriatrics
