应用超声多普勒观测在症状性单侧颈动脉狭窄患者血管内安放支架成形术前后脑血管储备功能变化.docVIP

应用超声多普勒观测在症状性单侧颈动脉狭窄患者血管内安放支架成形术前后脑血管储备功能变化 　　摘要：目的 研究症状性单侧颈动脉严重狭窄患者血管内支架成形术前后脑血管储备功能的变化。方法 脑血管储备功能评估采用经颅多普勒超声（TCD）检测屏气导致的高碳酸血症对大脑中动脉血流速度的影响。比较15例症状性单侧颈动脉严重狭窄患者、15例无症状颈动脉狭窄患者和10例正常对照者的屏气指数，并比较分析15例症状性颈动脉狭窄患者在颈动脉支架成形术（CAS）前后的BHI的变化。结果 症状性单侧颈动脉狭窄患者狭窄侧的BHI（0.50±0.2）明显低于无症状颈动脉狭窄患者的狭窄侧（0.90±0.3，P0.05）。CAS术后症状性单侧颈动脉狭窄患者狭窄侧的BHI与术前相比明显改善（1.05±0.2，P0.05）。结论 症状性单侧颈动脉严重狭窄患者狭窄侧的脑血管储备功能受损明显，CAS术后显著改善。 　　关键词：颈动脉狭窄；脑血管储备功能；经颅多普勒超声；屏气指数 　　Analysis of Cerebral Vascular Reserve Function in Patients with Symptomatic Unilateral Carotid Stenosis by Doppler Ultrasound 　　ZUO Zong-ju 　　（The First Affiliated Hospital of Bengbu Medical College，Bengbu 233000，Anhui，China） 　　Abstract：Objective To Analyzethechangesofcerebrovascular reserve capability in symptomatic patients with unilateral severe carotidstenosis before and after carotid angioplasty and stenting（CAS）.Methods Using transcranial Doppler（TCD），the cerebrovascular reserve capability was evaluated with the breath-holding index（BHI）.The changes of flow velocity in the middle cerebral arteries after hypercapnia induced by breath-holdin were detected.We studied the BHI in 15 symptomatic and 15 asymptomatic patients with unilateral severe carotid stenosis and 10 control subjects.The changes of BHI in symptomatic patients with carotid stenosis before and after CAS were compared.Results BHI was significantly lower（P0.05）in BHI was detected on the normal side of symptomatic（0.92±0.3）and asymptomatic（1.05±0.2）patients，and in control subjects.BHI significantly increased（P0.001）on the stenotic side（1.05±0.2）while remaining substantially stable on the normal side of symptomatic patients（1.10±0.2）After CAS.Conclusion Impaired cerebrovascular reserve capability in the stenotic side of symptomatic patients with unilateral severe carotid stenosis were significantly improved after CAS. 　　Key words：Cerebrovascular reserve capability；Carotid stenosis；Transcranial Doppler；Breath-holding index 　　颈动脉粥样硬化性狭窄是缺血性卒中的危险因素之一，其机制不仅包括斑块脱落造成的远端脑动脉栓塞，而且还涉及