TCD检测脑梗死患者微栓子阳性与临床危险因素的相关性分析

摘要

目的 探讨经颅多普勒(transcranial Doppler ultrasongraphy,TCD)监测脑梗死患者微栓子(microembolus,MES)阳性与临床各危险因素的相关性,研究MES 阳性在脑梗死病程中的作用机制及意义.方法 采用Companion Ⅲ型TCD 机,双通道2MHz 监测探头,检测233例前循环供血区脑梗死患者循环中MES数.采集外周血标本行实验室检查.结果 脑梗死患者MES 阳性率为21.89 %;MES 阳性与高血脂相关较弱,与脑多发性梗死的相关性中等,与大动脉狭窄相关性最强.结论 MES阳性可能与动脉狭窄斑块有关,粥样硬化斑块是MES的主要来源,MES 阳性说明患者有活动性栓子来源的基础,MES的存在极易导致脑梗死发生或复发.%Objective To explore the relationship between positive microemboli ( MES ) and each clinical risk factor in patients with cerebral infarction and study the mechanism and significance of positive MES in the course of cerebral inffarction. Methods The micro embolus number in 233 cases of anterior circulation inffarction was detected by Companion Ⅲ type transcranial Doppler uhrasongraphy (TCD) machine, double channel 2 MHz detection probes. Peripheral blood specimens were tested by clinical laboratory. Results The MES positive rate was 21.89％ in patients with cerebral infarction. MES positive rate showed a weaker correlation with hyperlipidemia, an intermdiate correlation with muhiple cerebral infarctions and a strongest correlation with artery stenosis. Conclusion Positive MES might be related with artery stenosis plaques and atherosclerotic plaque is the major source of MES. The positive MES shows that patients have the active embolus sources and have risk of occurrence and recurrence of cerebral infarction.