【摘要】 目的探讨经颅多普勒超声和颈部血管超声在诊断脑梗死患者中的应用及临床意义。方法选择2014年6月至2016年2月在漯河市中心医院就诊的脑梗死患者87例,按照患者年龄大小分为老年组(48例)、中年组(25例)和青年组(14例),3组患者入院后均采用经颅多普勒超声和颈部血管超声进行诊断,比较2种方法在不同年龄组患者中的诊断结果。结果经颅多普勒超声检查结果显示,老年组患者的颅内血管狭窄、脑动脉硬化和颅内动脉前循环狭窄比例分别为41.7%(20/48)、75.0%(36/48)和20.8%(10/48),中年组患者分别为44.0%(11/25)、28.0(7/25)和28.0%(7/25),青年组患者分别为42.9%(6/14)、7.1%(1/14)和42.9%(6/14);3组患者的颅内血管狭窄比例组间比较差异均无统计学意义(P>0.05);老年组患者的脑动脉硬化比例显著高于中年组和青年组,中年组显著高于青年组(P<0.05);老年组患者的颅内动脉前循环狭窄比例低于中年组和青年组,中年组低于青年组(P<0.05)。经颈部血管超声检查结果显示,老年组患者的斑块形成、颈部血管狭窄和颈内动脉颅外段狭窄比例分别为83.3%(40/48)、68.8%(33/48)和33.3%(16/48),中年组患者分别为40.0%(10/25)、32.0%(8/25)和24.0%(6/25),青年组患者分别为7.1%(1/14)、14.3%(2/14)和14.3%(2/14),老年组患者的斑块形成、颈部血管狭窄、颈内动脉颅外段狭窄比例均显著高于中年组和青年组,中年组患者均显著高于青年组(P<0.05)。结论不同年龄脑梗死患者通过经颅多普勒超声和颈部血管超声诊断可以反映患者的颅外和颅内供血动脉的血管病变,并且检查方便、快速、经济、无创伤,易为患者所接受,是脑梗死患者2种可靠的检查手段。更多还原

【Abstract】 Objective To explore the effect of transcranial Doppler ultrasound and neck vascular ultrasound in diagnosis of cerebral infarction and its clinical significance. Methods Eighty-seven patients with cerebral infarction were selected in Luohe Central Hospital from June 2014 to February 2016. The patients were divided into elderly group( n = 48),middle age group( n = 25) and the young group( n = 14) according to the patients’ age. All patients underwent transcranial Doppler ultrasonography and neck vascular ultrasound diagnosis,the diagnosis results of patients were compared among the three groups. Results The transcranial Doppler ultrasound examination results show that the rate of intracranial vascular stenosis,cerebral arteriosclerosis and procyclic stenosis of intracranial artery of patients in elderly group was 41. 7%( 20/48),75. 0%( 36/48)and 20. 8%( 10/48) respectively; in middle age group was 44. 0%( 11/25),28. 0( 7/25) and 28. 0%( 7/25) respectively; in young group was 42. 9%( 6/14),7. 1%( 1/14) and 42. 9%( 6/14). There was no statistic difference in the rate of intracranial vascular stenosis among the three groups( P > 0. 05). The rate of cerebral arteriosclerosis of patients in the elderly group was significantly higher than that in the middle age group and young group( P < 0. 05); the rate of cerebral arteriosclerosis of patients in the middle age group was significantly higher than that in the young group( P < 0. 05). The rate of procyclic stenosis of intracranial artery of patients in the elderly group was significantly lower than that in the middle age group and young group( P < 0. 05); the rate of procyclic stenosis of intracranial artery of patients in the middle age group was significantly lower than that in the young group( P < 0. 05). The neck vascular ultrasound examination results show that the rate of plaque formation,neck vascular stenosis and extracranial internal carotid artery stenosis of patients in elderly group was 83. 3%( 40/48),68. 8%( 33/48) and 33. 3%( 16/48) respectively; in middle age group was 40. 0%( 10/25),32. 0%( 8/25) and 24. 0%( 6/25) respectively; in young group was 7. 1%( 1/14),14. 3%( 2/14) and 14. 3%( 2/14) respectively. The rates of plaque formation,neck vascular stenosis and extracranial internal carotid artery stenosis of patients in elderly group were significantly higher than those in the middle age group and young group( P < 0. 05); the rates of plaque formation,neck vascular stenosis and extracranial internal carotid artery stenosis of patients in middle age group were significantly higher than those in the young group( P < 0. 05). Conclusions The diagnosis results of transcranial Doppler ultrasound and neck vascular ultrasound in different age cerebral infarction patients are different. The above two diagnosis method can reflect the vascular lesions of extracranial and intracranial feeding artery. The transcranial Doppler ultrasound and neck vascular ultrasound check are convenient,fast,economic,no trauma,and easily accepted by patients. So they are reliable method for the diagnosis of cerebral infarction.更多还原