首页|经颅多普勒联合经胸超声心动图发泡试验对偏头痛患者脑血流特征的评估

经颅多普勒联合经胸超声心动图发泡试验对偏头痛患者脑血流特征的评估

扫码查看
目的 联合应用经颅多普勒发泡试验(cTCD)和经胸超声心动图声学造影(cTTE)技术,评估不同分级卵圆孔未闭(PFO)伴偏头痛患者之间脑血流动力学参数的变化。方法 选取空军军医大学第二附属医院的偏头痛患者85名,联合应用 cTCD和cTTE判断受检者是否存在PFO导致的右向左分流(PFO-RLS)并根据分级标准进行分流程度分级(0、Ⅰ、Ⅱ、Ⅲ级)。同时应用TCD分别观察Valsalva动作(VM)前后大脑中动脉(MCA)收缩期峰值血流速度(Vs)、平均血流速度(Vm)、舒张期峰值血流速度(Vd)、阻力指数(RI)和搏动指数(PI)等超声参数的特征,并对比分析PFO-RLS 0级与PFO-RLS Ⅰ、Ⅱ、Ⅲ级患者之间以上超声参数的差异。结果 85例受检者中,偏头痛伴PFO-RLS 0级患者13例,偏头痛伴PFO-RLS Ⅰ级患者34例,偏头痛伴PFO-RLS Ⅱ 级患者17例,偏头痛伴PFO-RLSⅢ 级患者21例。结果 显示VM前偏头痛伴PFO-RLS Ⅱ级患者比偏头痛伴PFO-RLS 0级患者的Vs、Vm、Vd血流速度增快,差异有统计学意义(P<0。05);VM后偏头痛伴PFO-RLS Ⅲ级者比偏头痛伴PFO-RLS 0级患者的Vm、Vd增快,差异有统计学意义(P<0。05)。结论 不同分级PFO-RLS伴偏头痛患者之间脑血流变化趋势不同,根据脑血流特征性变化,可为偏头痛患者的病因诊断及治疗提供一定的临床理论依据。
Value of transcranial Doppler foaming test combined with transthoracic echocardiography in evaluating cerebral blood flow characteristics in patients with migraine
Objective To investigate the changes in cerebral hemodynamic parameters in patients with migraine and different grades of patent foramen ovale(PFO)using contrast-enhanced transcranial Doppler(cTCD)foaming test and contrast-enhanced transthoracic echocardiography(cTTE).Methods A total of 85 patients with migraine in our hospital were enrolled,and cTCD and cTTE were used in combination to determine whether a subject had right to left shunt(PFO-RLS)caused by PFO,which was graded according to the grading criteria(grades 0,Ⅰ,Ⅱ,and Ⅲ).Meanwhile,TCD was used to observe the ultrasound parameters of the middle cerebral artery before and after Valsalva maneuver(VM),in-cluding peak systolic blood flow velocity(Vs),mean blood flow velocity(Vm),peak diastolic blood flow velocity(Vd),resistance index,and pulsatility index,and these ultrasound parameters were compared between grade 0 PFO-RLS and grade Ⅰ/Ⅱ/Ⅲ PFO-RLS.Results Among the 85 subjects,13 patients had migraine with grade 0 PFO-RLS,34 patients had migraine with grade I PFO-RLS,17 patients had migraine with grade Ⅱ PFO-RLS,and 21 patients had migraine with grade Ⅲ PFO-RLS.The results before VM showed that compared with the patients with migraine and grade 0 PFO-RLS,the patients with migraine and grade Ⅱ PFO-RLS had significant increases in Vs,Vm,and Vd(P<0.05),and the results after VM showed that compared with the patients with migraine and grade 0 PFO-RLS,the patients with migraine and grade Ⅲ PFO-RLS had significant increases in Vm and Vd(P<0.05).Conclusion There are different changing trends of cerebral blood flow in patients with migraine and different grades of PFO-RLS,and the characteristic changes in cere-bral blood flow can provide a certain clinical theoretical basis for the etiological diagnosis and treatment of patients with mi-graine.

Transcranial DopplerFoaming testEchocardiography of the right heartMigraineCerebral blood flow velocity

阴玮伟、闫灵娟、金京兰、程洪瑜、王佳

展开 >

空军军医大学第二附属医院超声科,陕西 西安 710038

经颅多普勒 发泡试验 右心声学造影 偏头痛 脑血流速度

空军军医大学第二附属医院尖子人才项目

2024

中风与神经疾病杂志
吉林大学

中风与神经疾病杂志

CSTPCD
影响因子:0.754
ISSN:1003-2754
年,卷(期):2024.41(10)