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目的分析导致大脑后动脉搏动指数(PI_(PCA))减低的因素。方法回顾性连续纳入经颅多普勒超声(TCD)检出的PI_(PCA)减低患者143例(单侧组43例,双侧组100例),对比分析两组患者年龄、性别、脑血管病危险因素、临床症状、体征及颈动脉彩色多普勒超声、CTA/DSA、CT/MRI等影像学资料。结果 (1)单侧组中3例(3/43)患者有脑出血病史,双侧组中100例均无脑出血病史,两组差异有统计学意义(χ~2=7.126,P=0.008),两组间的临床资料差异无统计学意义。(2)两组患者健侧大脑中动脉搏动指数(PI_(MCA))与患侧PI_(PCA)之间的差为0.33(0.27~0.48)vs 0.33(0.24~0.43),两组间差异无统计学意义(P>0.05)。(3)以DSA/CTA为标准,双侧PI_(PCA)减低多见于双侧椎动脉(VA)病变或基底动脉(BA)病变;单侧PI_(PCA)减低多见于单侧PCA自身病变以及胚胎型大脑后动脉(FPCA)存在的情况。结论 PI_(PCA)的减低是反映PCA供血区低灌注的客观指标,分析导致PI_(PCA)减低的因素,有助于临床症状的综合评估及进一步选择检查手段和制定治疗方案。
Objective To analyze the factors leading to the decrease of posterior cerebral artery pulsatility index (PI_ (PCA)). Methods A total of 143 patients (43 in unilateral group and 100 in bilateral group) were retrospectively enrolled in the study. Among them, age, gender, cerebrovascular Disease risk factors, clinical symptoms and signs and carotid color Doppler ultrasound, CTA / DSA, CT / MRI and other imaging data. Results (1) All three patients (3/43) in unilateral group had a history of intracerebral hemorrhage. None of the 100 patients in both groups had a history of intracerebral hemorrhage. There was a significant difference between the two groups (χ ~ 2 = 7.126, P = 0.008 ), No significant difference between the two groups clinical data. (2) The difference between the contralateral cerebral artery pulsatility index (PI_ (MCA)) and the affected PCA in the two groups was 0.33 (0.27-0.48) vs 0.33 (0.24-0.43), with no difference between the two groups Statistical significance (P> 0.05). (3) According to the DSA / CTA criteria, bilateral PCA reduction was more common in bilateral vertebral artery (VA) or basilar artery (BA) lesions. Unilateral PI_ (PCA) reduction was more common in unilateral PCA lesions and Embryonic posterior cerebral artery (FPCA) exists. Conclusions The decrease of PI_ (PCA) is an objective index to reflect the hypoperfusion of PCA. The factors leading to the decrease of PI_ (PCA) are analyzed. It is helpful for the comprehensive evaluation of clinical symptoms and further selection of examination methods and treatment planning.