2型糖尿病合并急性腔隙性脑梗死患者颅内动脉搏动指数的临床意义

摘要

Objective To explore the clinical significance of intracranial arterial pulsatility index (PI) in patients with type 2 diabetes mellitus combined with acute lacunar infarction.Methods The middle cerebral artery (MCA) of 48 patients with type 2 diabetes mellitus combined with acute lacunar infarction (DM-L group),65 patients with type 2 diabetes mellitus without cerebral infarction (DM-N group) and 59 normal controls (normal control group) were examinated by Transcranial Doppler (TCD).The speed of blood flow and PI were record.The results were compared.Results Eighteen patients who failed with temporal window detection,mean glow velocity significantly increased and showed arteriostenosis were eliminated.DM-L group was in 7 cases,DM-N group in 5 cases and normal control group in 6 cases.PI of bilateral side in DM-L group and DM-N group were significantly higher than those in normal control group (all P ＜0.001).PI of bilateral side in DM-L group was significantly higher than those in DM-N group (all P ＜ 0.05).Conclusions The elevated PI of intracranial arteries may reflect the degree of microangiopathy in type 2 diabetes mellitus patient.PI may be a useful predictor of type 2 diabetes mellitus patients combined with acute lacunar infarction.%目的 探讨2型糖尿病合并急性腔隙性脑梗死患者的颅内动脉搏动指数(PI)的临床意义.方法 应用经颅多普勒(TCD)分别检测48例2型糖尿病合并急性腔隙性脑梗死者(DM-L组)、65例2型糖尿病无脑梗死患者(DM-N组)及59例健康对照者(正常对照组)的大脑中动脉(MCA),记录其血流速度及PI.对检查结果进行比较.结果 排除颞窗探测失败和平均流速明显增高并提示有显著大动脉狭窄的患者18例,其中DM-L组7例、DM-N组5例、正常对照组6例.DM-L组和DM-N组双侧PI均显著高于正常对照组(均P ＜0.001).DM-L组双侧PI显著高于DM-N组(均P＜0.05).结论 颅内动脉PI增高可以反映2型糖尿病患者微血管病变程度.PI可以作为2型糖尿病并发急性腔隙性脑梗死的预测指标.