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目的：监测短暂脑缺血发作（ＴＩＡ）患者大脑中动脉微栓子的出现频率，了解其发病机制，确定缺血性卒中的高危人群。方法：应用德国ＥＭＥＴＣ－４０４０型经颅多普勒超声（ＴＣＤ）检测仪对４３例发病１２天以内的颈动脉系统ＴＩＡ患者进行微栓子监测，监测前常规测定颅内外各血管的血流狭窄、频谱形态及声频，以确定有无血管狭窄及狭窄部位。在病灶侧大脑中动脉的主干或于狭窄远端进行监测。监测时间每次３０～６０分钟。结果：３４例ＴＩＡ患者中发现栓子者２例占５．８８％，其中一例为大脑中动脉狭窄，另一例为修复性心脏瓣膜病患者。５例有颈部血管狭窄，１７例颅内血管狭窄。２例进展为脑梗塞者均未测到微栓子。结论：颅内血管狭窄的ＴＩＡ患者，动脉灌注损伤引起的低灌流状态在其发病机制中可能起到重要作用，而栓塞机制为次要原因。此外，大脑中动脉主干狭窄造成的局部血流紊乱，也给栓子监测带来困难。
OBJECTIVE: To monitor the frequency of occurrence of middle cerebral artery micro-emboli in patients with transient ischemic attack (TIA), understand its pathogenesis and determine the high risk of ischemic stroke. Methods: Forty-three TIA patients with carotid system within 12 days of onset were monitored by EMETC-4040 transcranial Doppler ultrasonography (TCD) in Germany. Before cerebral infarction, the blood flow of each vessel , Spectral patterns and audio to determine whether there are vascular stenosis and stenosis. The lesion side of the trunk of the middle cerebral artery or distal stenosis monitoring. Monitoring time every 30 to 60 minutes. Results: In 34 TIA patients, 2 cases were found embolus accounted for 5.88%, one case of middle cerebral artery stenosis, and the other cases of prosthetic heart valve disease. 5 cases had neck stenosis, 17 cases of intracranial stenosis. No progress was found in 2 patients with cerebral infarction. CONCLUSIONS: TIA patients with intracranial vascular stenosis may have an important role in the pathogenesis of hypoperfusion induced by arterial perfusion injury, with embolism as the secondary cause. In addition, local blood flow disorders caused by stenosis of the middle cerebral artery also cause difficulties in the monitoring of emboli.