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目的应用TCD联合自体CO2吸入法评价单侧颈内动脉系统血管狭窄患者的脑血流储备(CVR)。方法对单侧颈内动脉系统血管狭窄患者及正常人分别行自体CO2吸入,以TCD测定其基线状态及高碳酸血症状态下双侧大脑中动脉的血流速度,根据公式评价其CVR。结果对46例脑血管狭窄患者进行了双侧CVR的测定,其中患侧(1.41±0.88)%/mmHg,健侧(2.51±1.28)%/mmHg,两者比较有显著性差异(P<0.001)。脑血管狭窄患者患侧大脑中动脉的CVR与正常对照组[左侧(2.29±1.30)%/mmHg,右侧(2.19±1.09)%/mmHg]比较有显著性差异(95%CI0.001~0.026,P=0.033)。结论症状性单侧颈内动脉狭窄及单侧大脑中动脉狭窄患者的CVR受损。
Objective To evaluate the cerebral blood flow reserve (CVR) in patients with unilateral carotid artery stenosis by TCD combined with autologous CO2 inhalation. Methods Patients with unilateral internal carotid artery stenosis and normal subjects were respectively exposed to CO2 inhalation. The baseline blood flow velocity of the bilateral middle cerebral arteries was measured by TCD, and the CVR was evaluated according to the formula. Results 46 patients with cerebrovascular stenosis were measured with bilateral CVR, with 1.41 ± 0.88% / mmHg on the ipsilateral side and 2.51 ± 1.28% / mmHg on the contralateral side (P <0.001) ). The CVR of the affected side of the middle cerebral artery in patients with cerebrovascular stenosis was significantly different from that of the normal control group (2.29 ± 1.30% / mmHg on the left and (2.19 ± 1.09)% / mmHg on the right) (95% CI0.001 ~ 0.026, P = 0.033). Conclusions CVR is impaired in patients with symptomatic unilateral internal carotid artery stenosis and unilateral middle cerebral artery stenosis.