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目的探讨大脑中动脉脉动指数(PI)与缺血性脑卒中的关系。方法选取2013年12月—2015年3月西安医学院第二附属医院收治的缺血性脑卒中住院患者206例,其中腔隙性脑梗死患者62例,大面积脑梗死患者144例。记录患者的性别、年龄、体质指数及高血压、糖尿病、高纤维蛋白血症、高脂血症情况等缺血性脑卒中常见危险因素,采用经颅多普勒超声诊断仪探查患者双侧大脑中动脉,计算PI。比较所有患者患侧与健侧大脑中动脉PI、不同梗死类型患者患侧大脑中动脉PI及PI正常组(n=148)与PI偏高组(n=58)缺血性脑卒中常见危险因素,并采用多因素Logistic回归分析大脑中动脉PI偏高的影响因素。结果所有患者患侧大脑中脉PI高于健侧(P<0.05);腔隙性脑梗死患者患侧大脑中动脉PI与大面积脑梗死患者比较,差异无统计学意义(P>0.05)。PI偏高组患者女性所占比例、高龄者所占比例、高纤维蛋白血症发生率均高于PI正常组(P<0.05);多因素Logistic回归分析结果显示,高龄、肥胖和高纤维蛋白血症是大脑中动脉PI偏高的独立危险因素(P<0.05)。结论缺血性脑卒中患者大脑中动脉PI增高,高龄、肥胖及高纤维蛋白血症是缺血性脑卒中患者大脑中动脉PI升高的独立危险因素。
Objective To investigate the relationship between cerebral artery pulsatility index (PI) and ischemic stroke. Methods A total of 206 hospitalized patients with ischemic stroke admitted to the Second Affiliated Hospital of Xi’an Medical College from December 2013 to March 2015 were selected, including 62 lacunar infarcts and 144 cases of large-area cerebral infarction. The gender, age, body mass index and common risk factors of ischemic stroke such as hypertension, diabetes mellitus, hyperfibrinogenemia and hyperlipidemia were recorded. The transcranial Doppler ultrasound was used to detect the bilateral brain Middle artery, calculate PI. All patients were compared with PI in the ipsilateral middle cerebral artery and ipsilateral middle cerebral artery in normal control group (n = 148) and PI high group (n = 58). The common risk factors of ischemic stroke , And using multivariate Logistic regression analysis of factors affecting the high middle cerebral artery PI. Results The PI of the ipsilateral cerebral midbrain was higher than that of the healthy side in all patients (P <0.05). There was no significant difference between the ipsilateral middle cerebral artery (PI) and the large area cerebral infarction in lacunar infarction patients (P> 0.05). The proportion of women with high PI, the proportion of elderly, the incidence of hyperfibrinogenemia were higher than those of PI normal group (P <0.05). The multivariate Logistic regression analysis showed that age, obesity and high-fiber protein Serum hyperlipidemia was an independent risk factor for hypertension in the middle cerebral artery (P <0.05). Conclusion The PI of middle cerebral artery is increased in patients with ischemic stroke, and the elderly, obesity and hyperfibrinogenemia are independent risk factors of PI in middle cerebral artery in patients with ischemic stroke.