脑动静脉间脉搏波传导时间对腔隙性脑梗死的初步评价

摘要

目的 探讨脑动静脉间脉搏波传导时间(cerebral arerio-venous pulse wave time,CAV-PWT)与腔隙性脑梗死(lacunar infarction,LD的相关性.方法 按照病例对照研究方法,采集40例LI患者和20例对照组人口学资料和相关危险因素.采用经颅多普勒(transcranial dopple ultransonograp,TCD)仪同步监测颈内动脉终末段(terminal internal carotid artery,TICA)与基底静脉(Rosenthal's veins；venae basalis,BVR)的脉搏波,计算CAV-PWT,比较2组间CAV-PWT的差异,以及分析CAV-PWT与人口学资料和危险因素间的关系.结果 病例组患者的CAV-PWT(73.53±15.81 ms)与对照组(106.02±28.06 ms)比较明显缩短(P＜0.05).多元回归分析显示:CAV-PWT与体重指数X1和年龄X3负相关(rs=-0.697与-0.3258,P＜0.05),与头围、性别、血糖、血脂和血压无明显相关性.回归方程Y=210.168-4.661X1-0.459X3.Logistic回归分析显示:年龄X3、PWTX4和高血压X9是LI的危险因素(P＜0.05),其回归方程logit P=-8.034-2.178X1+5.066X3+3.775X4+4.865X9(x 2=20.181,P＜0.01).结论 LI患者CAV-PWT明显缩短,可能与脑小动脉硬化有关.%Objective To investigate the relationship between cerebral arerio-venous pulse wave time (CAV-PWT) and lacunar infarction. Methods Forty patients with lacunar infarction and 20 sex-and-age-matched control subjects were studied. The pulse wave of terminal internal carotid artery and basal vein were simultaneously monitored by TCD and the CAV-PWTs were then calculated. The difference in CAV-PWT between patients and controls and the relationships of CAV-PWT with demographic data and risk factors were analyzed. Results The CAV-PWT was significantly shorten in patient group than in control group (73.53 ± 15.81 ms vs 106.02 ± 28.06 ms) (P < 0.05). Multiple linear regression revealed that CAV-PWTs were negatively correlated with body mass index and age (rs= -0.697 and -0.3258, P < 0.05), but not with head circumference, gender, blood sugar, blood fat or blood pressure. The regression equation was: Y = 208.928-4.661X1-0.459X3 (F = 22.358, P < 0.001) Logistic regression analysis showed that age, PWT and high blood pressure were risk factors for lacunar infarction(P < 0.05). The regression equation was logit P = -8.034 + 5.066X3 + 3.775X4 + 4.865X9(X2 = 20.181, P < 0.01). Conclusions The CAVPWT is significantly shorten in lacunar infarction, which may be associated with cerebral arteriolosclerosis.