摘要
目的通过对患者大脑中动脉血管反应性(CVR)与椎动脉CVR的比较,评估颅内外大动脉无狭窄但发生后循环梗死(PCI)患者CVR,探讨前后循环血流动力学变化在预测PCI发生中的作用。方法选择PCI患者27例(PCI组),选择同期健康体检者25例(对照组)。采用经颅多普勒超声结合CO2吸入试验检测所有入选患者的大脑中动脉CVR和椎动脉CVR。结果与对照组比较,PCI组左侧和右侧大脑中动脉CVR明显下降[(25.96±15.90)%vs(34.63±8.60)%,(26.40±14.54)%vs(34.49±9.08)%,P<0.05];PCI组椎动脉CVR较对照组有下降,但差异无统计学意义(P>0.05)。多变量线性回归分析显示,糖尿病是大脑中动脉CVR受损的独立危险因素(β=-0.116,P=0.035)。结论大脑中动脉CVR下降,而非椎动脉CVR下降,可作为颅内外大动脉无狭窄患者发生PCI预测指标。对于颅内外大动脉无明显狭窄的患者,糖尿病是大脑中动脉CVR降低的独立危险因素。
Objective To assess the cerebrovascular reactivity （CVR） in patients with posterior cir- culation infarction（PCI） but without intra- and extracranial conducting artery stenosis. Methods Twenty-seven PCI patients served as a PCI group and 25 subjects undergoing physical examina- tion served as a control group in this study. The CVR in middle cerebral artery （MCA） and verte- bral artery （VA） was detected by transcranial Doppler uhrasonography combined with CO2 inha- lation test. Results The CVR in left and right MCA was significantly lower in PCI group than in control group （25.96±15.90）%vs（34.63±8.60）%,（26.40±14.54）%vs（34.49±9.08）%,P〈0.05）. No significant difference was found in CVR between the two groups although it was higher in PCI group than in control group （P 〉 0. 05）. Multivariate linear regression analysis showed that diabetes was the independent risk factor for CVR in MCA （β=-0. 116 ,P=0. 035）. Conclusion Reduced CVR in MCA rather than CVR in VA can be used as an independent predic- tor of PCI. Diabetes is an independent risk factor for reduced CRV in MCA of patients without in- tra- and extracranial conducting artery stenosis.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2014年第4期404-406,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
国家自然科学基金(81070923)
江苏省自然科学基金(BK2011663)
关键词
梗死
大脑中动脉
血流动力学
椎动脉
糖尿病
超声检查
多普勒
经颅
危险因素
infarction, middle cerebral artery
hemodynamics
vertebral artery
diabetes mellitus
uhrasonography, Doppler, transcranial
risk factors
