癫痫亚临床发作的脑血流动力学监测

摘要

目的:探讨癫痫亚临床发作过程中脑血流动力学监测的价值.方法:对30例癫痫亚临床发作患者同步进行经颅多普勒及脑电图连续监测,对发作前1 min及发作后1、5、10和20 min的监测资料进行分析.结果:经重复测量数据的方差分析,癫痫哑临床发作前后大脑中动脉的收缩期峰血流速度、平均血流速度、舒张期末血流速度、搏动指数及心率差异均有统计学意义(F=69.880、78.716、58.393、119.209和164.268,P均＜0.001),与发作前比较,发作后l min收缩峰血流速度、平均血流速度、舒张期末血流速度及心率最快(P均＜0.001),搏动指数最低(P＜0.001).结论:癫痫哑临床发作时脑血流动力学有其独特的规律,经颅多普勒监护显示脑血流速度突然增快提示癫痫亚临床发作.%Aim:To investigate the value of transcranial Doppler (TCD) in haemodynamic monitoring of sub-clinical epilepsy. Methods:Thirty patients with sub-clinical epilepsy were continuously monitored by TCD and electroencephalogram (EEG). TCD data of five time points were analyzed, including 1 min before sub-clinical epilepsy attack, 1,5,10,and,20 min after sub-clinical epilepsy attack. Results: There were significant differences of systolic velocity (vs) , mean velocity (vm) , diastolic velocity (vd) , pulsatility index (PI) of middle cerebral artery ( MCA) and heart rate (HR) between pre-and post- sub-clinical epilepsy (F = 69.880, 78.716, 58.393, 119.209, and 164.268, P<0.001).vs, vm, vd and HR reached the peek ( P < 0. 001 ) , and PI was lowest 1 min after sub-clinical epilepsy attack ( P < 0. 001 ). Conclusion: There is typical haemodynamic change during sub-clinical epilepsy attack. Abrupt increase of cerebral blood flow in TCD shows that there will be sub-clinical epilepsy attack.