对颈动脉狭窄TCD达峰时间变化的分析

发布时间：2018-02-22 14:02

本文关键词： 经颅多普勒超声达峰时间颈动脉狭窄　出处：《福建医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：本研究以颈动脉狭窄病人为研究对象，探究颈动脉狭窄经颅多普勒超声（TCD）频谱特征，旨在评估达峰时间是否可成为经颅多普勒评估颅内外血管狭窄的参考指标。方法：收集1周内先后行颈动脉CTA和TCD检查病例196例，目标血管为双侧颈内动脉、大脑中动脉、椎动脉以及基底动脉。全部病例中CTA证实有狭窄的目标血管共有281条。根据CTA检查结果分三组：正常对照组、轻度狭窄组、中重度狭窄组。记录各目标血管的血流速度（Vs、Vm），搏动指数，阻力指数以及频谱形态。同时，在每条血管频谱上取一较清晰单个频谱为观察单位，确定心搏周期起点（T0）、收缩峰点（S）、舒张峰点（D），以及心搏周期末点。计算达峰时间SPT、DPT，并计算二者分别占整个心搏周期T的比例（SPT/T、DPT/T）。比较三组间SPT、DPT、SPT/T、DPT/T的差异。结果：1.整体分析时,SPT、SPT/T在中重度狭窄组较正常组、轻度狭窄组均大，在后两组之间则无差异。在前循环分析时得到与整体分析一致的结果。在后循环中SPT仅在中重度狭窄组和对照组间有显著差异,在轻度狭窄组与其余两组间无显著差异；而SPT/T在三组之间的均有显著差异，表现为随狭窄程度加重而增大。 2.无论在前循环还是后循环亦或是整体分析，DPT、DPT/T在三组之间均无显著差异。 3.对单侧大于50%狭窄的血管与其对侧同名血管配对分析发现，，在大于50%狭窄侧SPT、SPT/T较大，DPT、DPT/T较小，均有统计学差异。结论：1.达收缩峰时间指标在大于50%以上狭窄血管中较大，故达收缩峰时间可能成为颅内外血管狭窄较客观而方便的新指标； 2.达舒张峰时间缩短在颅内外血管狭窄评估中可能有意义.
[Abstract]:Objective: to investigate the characteristics of transcranial Doppler echocardiography (TCD-TCD) in patients with carotid artery stenosis in order to evaluate whether the peak time can be used as a reference index for the evaluation of intracranial and extracranial vascular stenosis by transcranial Doppler. Methods: one week later, 196 cases of carotid artery CTA and TCD were collected. The target blood vessels were bilateral internal carotid artery and middle cerebral artery. Vertebral artery and basilar artery. There were 281 target vessels confirmed by CTA in all cases. According to the results of CTA examination, they were divided into three groups: normal control group, mild stenosis group. The blood flow velocities, pulsatility index, resistance index and spectral morphology of each target vessel were recorded. At the same time, a clear and single spectrum was taken as a unit of observation on each vessel spectrum. To determine the starting point of cardiac cycle, systolic peak, diastolic peak, and the end of cardiac cycle. Calculate the peak time (SPTT), calculate the ratio of the two to the whole cardiac cycle T and compare the difference of SPTDPTSPT / TDPTP / T between the three groups. Results: 1. SPT / T in moderate and severe stenosis group was larger than that in normal group, and that in mild stenosis group was larger than that in mild stenosis group. There was no difference between the latter two groups. The results were consistent with the global analysis in the anterior circulation analysis. In the posterior circulation, there was significant difference only between the moderate and severe stenosis group and the control group, but there was no significant difference between the mild stenosis group and the other two groups. However, there were significant differences among the three groups in SPT/T, which increased with the severity of stenosis. 2. There was no significant difference in DPTP / T between the three groups either in the anterior or posterior cycles or in the global analysis. 3. The pairing analysis of the vessels with unilateral stenosis greater than 50% and the contralateral homonym showed that the SPTT / T of the stenotic side was larger than that of the control group and the DPTT / T of the stenosis was smaller than that of the control group, and there was statistical difference between the two sides. Conclusion (1) the peak systolic time is larger in the stenosis vessels than 50%, so the peak systolic time may be a new objective and convenient index for the stenosis of the intracranial and extracranial vessels. 2. Shortening diastolic peak time may be of significance in the evaluation of intracranial and extracranial vascular stenosis.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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