摘要
目的分析脑梗死患者的双功能彩超（CDI）和经颅多普勒（TCD）表现，探讨其对分水岭脑梗死（CWI）的诊断价值。方法回顾性分析经MRI诊断的142例CWI患者（研究组）和150例其他类型脑梗死（对照组）患者的CDI和TCD结果，对比两组患者血管狭窄情况、斑块检出率、斑块性质、斑块积分、发病前低血容量诱因情况、交通支的开放情况，分析CWI的发病机制。结果研究组142例，血管重度狭窄或闭塞72例，中度狭窄21例，轻度狭窄31例，无狭窄18例；对照组150例，其中重度狭窄或闭塞19例，中度狭窄41例，轻度狭窄23例，无狭窄67例，两组比较差异有统计学意义（x2=66．583，P=0．000）。研究组检出斑块115例（80．99％），对照组74例（49．33％），两组斑块检出率比较差异有统计学意义（x2=32．010，P=0．000）。研究组斑块积分为（11．47±3．78）分，对照组为（6．57±3．53）分，组间比较差异有统计学意义（t=4．019，P=0．001）。研究组78例（54．93％）发病前有明确低血容量病因，与对照组[11．33％（17／150）]比较差异有统计学意义（X2=63．164，P=0．000）。研究组有交通支开放共50例（35．31％），与对照组[25．33％（38／150）]比较差异无统计学意义（x2=3．381，P=0．066）。结论血管狭窄、不稳定粥样硬化斑块形成的微栓子、低血容量造成的脑局部低灌注均是CWI的发病机制。CDI和TCD联合应用可为临床血管评价及治疗提供很大帮助。
Objective To investigate the pathogenesis of cerebral watershed infarction （CWI） through analyzing the appearance examined by Color duplex Imaging （CDI） and transcranial doppler （TCD）. Methods One hundred and forty-two patients with CWI diagnosed by magnetic resonance imaging（MRI） were enroiied in the study group and 150 patients with acute cerebral infarction were enrolled in the control group. The results of CDI and TCD were retrospectively analyzed of the two groups. The vascular stenosis, plaque detection rate, plaque characteration, plaque scores, the cause of low blood volume, intracranial collateral circulation werecompared between the two groups to investigate the pathogenesis of CWI. Results Among the 142 cases in the study group, there were 72 cases of severe stenosis and occlusion, 21 cases of moderate stenosis, 31 cases of mild stenosis and 18 cases without stenosis and there were 19 cases of severe stenosis and occlusion, 41 cases of moderate stenosis, 23 cases of mild stenosis and 67 cases without stenosis among the 150 cases in the control group. There were significant differences in the two groups （ X2 = 66. 583, P = 0. 000 ）. There were significant differences on the plaque detection rate between the two groups （ 80. 99% （ 115/142 ） vs 49.33% （ 74/150 ）, X2 = 32. 010 ,P = 0. 000）. There were significant differences on the scores of plaque between the study group and the control group （ （ 11.47 ±3.78 ） points vs （ 6. 57 ± 3.53 ） points, t = 4. 019, P = 0. 001 ）. There were significant differences on the defined cause of low blood volume between the study group and the control group （54. 93% （78/142） vs 11.33% （ 17/150 ）, X2 = 63. 164, P = 0. 000）. There were 50 patients had collateral circulation in the study group and 38 cases in the control group, there were no significant differences between the two groups （35. 31% （50/142） vs 25. 33% （38/150） ,x2 = 3. 381 ,P =0. 066）. Conclusion Angiostegnosis, mieroemboli from the unstable
出处
《中国综合临床》
2013年第9期908-911,共4页
Clinical Medicine of China
关键词
分水岭脑梗死
双功能彩超
经颅多普勒
Cerebral watershed infarction
Color duplex Imaging
Transcranial Doppler
