论文部分内容阅读
背景:小脑顶核刺激具有调节和扩张血管的功能,可以明显增加局部脑血流,但其作用机制是否通过改善血管内皮功能尚不明确。目的:研究电刺激小脑顶核对老年短暂性脑缺血发作患者血流介导的血管舒张功能的影响,探讨其对短暂性脑缺血发作患者血管的保护作用机制。设计:以患者为研究对象,以诊断为依据的随机对照研究。单位:一所大学医院的综合科、康复室及超声波室联合进行的课题研究。对象:2001-02/2002-10华中科技大学同济医学院附属同济医院综合科住院的年龄>60岁的44例短暂性脑缺血发作患者,排除既往有脑出血或脑梗死、心房纤颤及其他心律失常或心力衰竭、血液系统疾病患者。随机分为治疗组(22例):小脑顶核刺激+常规治疗;对照组(22例)为常规治疗组。方法:采用高分辨率超声技术和肱动脉充血反应法,检测短暂性脑缺血发作患者治疗前后肱动脉内径变化率。主要观察指标:短暂性脑缺血发作患者治疗前后肱动脉内径变化率。结果:电刺激小脑顶核治疗组治疗前后肱动脉内径变化率由(4.59±3.32)%增至(10.34±3.13)%,治疗前后比较差异有显著性意义(t=5.91,P<0.01),对照组治疗前后肱动脉内径变化率由(4.68±3.20)%增至(5.10±3.29)%,差异无显著性意义(t=1.72,P>0.05),治疗后电刺激小脑顶核治疗组与对照组比较,差异有显著
BACKGROUND: Cerebellar supraoptic nucleus stimulation has the function of regulating and dilating blood vessels, which can obviously increase the local cerebral blood flow. However, it is unclear whether its mechanism of action is to improve endothelial function. Objective: To investigate the effects of electrical stimulation of the cerebellar fastigial nucleus on blood flow-mediated vasodilation in elderly patients with transient ischemic attack and to explore its protective mechanism on the blood vessels in patients with transient ischemic attack. Design: A randomized, controlled, patient-based, diagnosis-based study. Unit: A university hospital complex, rehabilitation and ultrasound room joint research project. PARTICIPANTS: Forty-four patients with transient ischemic attack who were hospitalized at Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from February 2001 to October 2002 were excluded from the patients with previous cerebral hemorrhage or cerebral infarction, atrial fibrillation and Other arrhythmias or heart failure, blood diseases. Randomly divided into treatment group (n = 22): cerebellar fastigial stimulation + routine treatment; control group (n = 22) as conventional treatment group. Methods: The high-resolution ultrasound and brachial artery hyperemia reaction method were used to detect the change rate of brachial artery diameter before and after transient ischemic attack. MAIN OUTCOME MEASURES: Rate of change of brachial artery diameter before and after treatment of transient ischemic attack. Results: The rate of change of internal diameter of brachial artery before and after electrical stimulation of cerebellar fastigial nucleus increased from (4.59 ± 3.32)% to (10.34 ± 3.13)%, there was significant difference before and after treatment (t = 5.91, P <0.01) The change rate of internal diameter of brachial artery before and after treatment in control group increased from (4.68 ± 3.20)% to (5.10 ± 3.29)%, there was no significant difference (t = 1.72, P> 0.05) The control group, the difference was significant