本文關(guān)鍵詞： 經(jīng)顱多普勒超聲 達(dá)峰時(shí)間 頸動(dòng)脈狹窄　出處：《福建醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：本研究以頸動(dòng)脈狹窄病人為研究對(duì)象，探究頸動(dòng)脈狹窄經(jīng)顱多普勒超聲（TCD）頻譜特征，旨在評(píng)估達(dá)峰時(shí)間是否可成為經(jīng)顱多普勒評(píng)估顱內(nèi)外血管狹窄的參考指標(biāo)。 方法：收集1周內(nèi)先后行頸動(dòng)脈CTA和TCD檢查病例196例，目標(biāo)血管為雙側(cè)頸內(nèi)動(dòng)脈、大腦中動(dòng)脈、椎動(dòng)脈以及基底動(dòng)脈。全部病例中CTA證實(shí)有狹窄的目標(biāo)血管共有281條。根據(jù)CTA檢查結(jié)果分三組：正常對(duì)照組、輕度狹窄組、中重度狹窄組。記錄各目標(biāo)血管的血流速度（Vs、Vm），搏動(dòng)指數(shù)，阻力指數(shù)以及頻譜形態(tài)。同時(shí)，在每條血管頻譜上取一較清晰單個(gè)頻譜為觀察單位，確定心搏周期起點(diǎn)（T0）、收縮峰點(diǎn)（S）、舒張峰點(diǎn)（D），以及心搏周期末點(diǎn)。計(jì)算達(dá)峰時(shí)間SPT、DPT，并計(jì)算二者分別占整個(gè)心搏周期T的比例（SPT/T、DPT/T）。比較三組間SPT、DPT、SPT/T、DPT/T的差異。 結(jié)果：1.整體分析時(shí),SPT、SPT/T在中重度狹窄組較正常組、輕度狹窄組均大，在后兩組之間則無(wú)差異。在前循環(huán)分析時(shí)得到與整體分析一致的結(jié)果。在后循環(huán)中SPT僅在中重度狹窄組和對(duì)照組間有顯著差異,在輕度狹窄組與其余兩組間無(wú)顯著差異；而SPT/T在三組之間的均有顯著差異，表現(xiàn)為隨狹窄程度加重而增大。 2.無(wú)論在前循環(huán)還是后循環(huán)亦或是整體分析，DPT、DPT/T在三組之間均無(wú)顯著差異。 3.對(duì)單側(cè)大于50%狹窄的血管與其對(duì)側(cè)同名血管配對(duì)分析發(fā)現(xiàn)，，在大于50%狹窄側(cè)SPT、SPT/T較大，DPT、DPT/T較小，均有統(tǒng)計(jì)學(xué)差異。 結(jié)論：1.達(dá)收縮峰時(shí)間指標(biāo)在大于50%以上狹窄血管中較大，故達(dá)收縮峰時(shí)間可能成為顱內(nèi)外血管狹窄較客觀而方便的新指標(biāo)； 2.達(dá)舒張峰時(shí)間縮短在顱內(nèi)外血管狹窄評(píng)估中可能有意義.
[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.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R743.3

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