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目的 应用经颅彩色多普勒超声与屏气试验研究脑梗死患者脑血管反应性。方法 选取37例大脑中动脉供血区脑梗死患者, 32例正常人,用经颅彩色多普勒显示并记录双侧大脑中动脉(MCA)彩色血流及多普勒频谱,嘱受检者作屏气试验,记录屏气末的多普勒频谱及屏气时间,测量屏气末双侧MCA血流速度、搏动指数(PI)、阻力指数(RI)等,计算屏气指数。结果 ①常规经颅彩色多普勒检查脑梗死患侧MCA峰值流速表现为异常加快(35. 1% )、降低(40. 5% )、正常(24. 4% )。②屏气时间在脑梗死组患侧、健侧和对照组间差异无显著性意义,但屏气指数差异有显著性意义,脑梗死组患侧屏气指数明显低于健侧和对照组(P<0. 05),脑梗死组健侧与对照组间差异无显著性意义。③脑梗死组患侧和健侧PI、RI高于对照组(P<0. 05),但屏气前、后差异无显著性意义;对照组PI、RI屏气后降低,与屏气前相比差异有显著性意义(P<0. 05)。结论 脑梗死患者脑血管的反应性降低,屏气指数能够反映脑血管的扩张性及储备能力,屏气试验是评价脑梗死患者脑血管反应性简便而可靠的方法。
Objective To study the cerebral vascular reactivity in patients with cerebral infarction by transcranial color Doppler ultrasound and breath hold test. Methods Thirty-seven middle cerebral artery infarction patients and 32 normal subjects were selected. Transcranial color Doppler was used to display and record the color flow and Doppler spectrum of bilateral middle cerebral artery (MCA) The breath hold test was used to record the Doppler spectrum and breath-holding time of the breath-holding gas. The bilateral breath-hold rate (MCA), pulsatility index (PI) and resistance index (RI) were measured. Results ① Conventional transcranial color Doppler examination of cerebral infarction MCA peak velocity was abnormally accelerated (35.1%), reduced (40.5%), normal (24.4%). (2) The duration of breath-hold time was not significantly different between the contralateral and contralateral sides of cerebral infarction group and the control group, but there was significant difference between the breath-hold index and the control group (P <0 There was no significant difference between contralateral cerebral infarction group and control group. (3) PI and RI of affected side and contralateral side of cerebral infarction group were higher than those of control group (P <0.05), but there was no significant difference between the two groups before and after breath holding; PI and RI of control group decreased after breath hold, There was a significant difference (P <0.05). Conclusions The reactivity of cerebrovascular in patients with cerebral infarction is decreased. The breath hold index can reflect the dilatation and reserve ability of cerebrovascular. The breath hold test is a simple and reliable method to evaluate cerebrovascular reactivity in patients with cerebral infarction.