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对107例脑分水岭梗塞(CWI)进行回顾性调查,发现它们在临床和经颅多普勒、影像学检查结果方面均有鲜明特点。与50例正常对照组的血压及脑血流速度比较,随平均动脉压幅度下降,CWI主要供血动脉的血流速度明显减慢(P<0.05)。发作性低血压以及引起血流动力学障碍的各种因素都可导致CWI发生。由于患者既往有高血压、心、脑血管疾病、糖尿病、颈动脉严重狭窄等病史,通过多种机理影响了大脑自动调节能力。患者血流动力学储备能力明显降低,即使血压波动不大,但脑血流量减少,也可发生缺血性卒中。
A retrospective survey of 107 cases of cerebral watershed infarction (CWI) found that they have distinct characteristics in clinical and transcranial Doppler, imaging findings. Compared with the blood pressure and cerebral blood flow velocity in 50 normal controls, the blood flow velocity of the main feeding artery of CWI was significantly decreased with the decrease of mean arterial pressure (P <0.05). Occurrence of paroxysmal hypotension and various factors that cause hemodynamic disorders can lead to CWI. Due to previous history of hypertension, heart, cerebrovascular disease, diabetes mellitus, severe carotid stenosis, etc., the ability of the brain to automatically regulate is affected by various mechanisms. Patients with hemodynamic reserve decreased significantly, even if the blood pressure fluctuations, but decreased cerebral blood flow, ischemic stroke can occur.