RESUMO
Objective To study the clinical application and value of transcranial Doppler (TCD) monitoring senile cerebral blood flow autoregulation in elderly.Methods Two hundred cases patients with elderly hypertension and 200 cases normal eldly from May 2011 to December 2014 in the Second People 's Hospital of Fengrun District of Tangshan were chosen as hypertension group and control group.Cerebral artery peak systolic velocity,supine with a vertical artery in the brain(MCA) cerebral blood flow difference (CBFV) and X-W wave duration, cerebrovascular hemodynamic parameters of two group were monitored by TCD method and compared.Results The peak values of left vertebral artery (LVA), right vertebral artery (RVA), the left coronary artery(LCS), and right vertebral artery(RCS) of hypertension group were significantly lower than those in the control group((38.01±12.42) cm/s vs (45.21±8.95) cm/s, (35.54±13.25) cm/s vs (43.52±7.06) cm/s, (66.12±9.52) m/s vs (76.54±8.19) cm/s, (71.24± 11.25) cm/s vs (77.98± 10.74) cm/s, (55.34 ±14.52) cm/s vs (61.24±12.58) cm/s,(48.12±15.24) cm/s vs (58.46±18.85) cm/s;t=4.6821, 5.6987,6.2589,4.3671,2.2854,4.9875;P＜ 0.01).The peak Vp, the difference between the horizontal and vertical position CBFV, X-W wave duration, the parameter of DR, Cp, C, Co, Zc, Wv of arterial blood vessels (left internal carotid artery (LICA), right internal carotid artery (RICA), left middle cerebral artery (LMCA), right middle cerebral artery(RMCA) ,left anterior cerebral artery(LACA), right anterior cerebral artery(RACA), left anterior cerebral artery (LOA), right middle cerebral artery (ROA)) of hypertension group were significantly higher than those of control group((96.38±18.85) cm/s vs (83.56±13.41) cm/s, (103.04±35.42) cm/s vs (85.62±29.63) cm/s, (99.85±23.54) cm/s vs (83.12±22.67) cm/s, (102.84± 16.42) cm/s vs (86.23 ±21.34) cm/s, (85.06± 15.36) cm/s vs (73.16± 10.35) cm/s, (85.64± 15.34) cm/s vs (70.52± 18.56) cm/s, (34.85±8.74) cm/s vs (28.56±7.85) cm/s, (35.12± 11.20) cm/s vs (30.05± 6.88) cm/s, (7.22 ± ±2.54) cm/s vs (2.78± 1.87) cm/s, (23.74±5.23) cm/s vs (20.85±4.35) cm/s, (378.35±35.12) Pa? s/cm vs (314.53±36.21) Pa? s/cm, (8.16± 0.62) P/kPa vs (7.25± 0.68) P/kPa, (0.41 ± 0.05) ml/kPa vs (0.33±0.06) ml/kPa, (1.15±0.16) mL/kPa vs (0.84±0.13) ml/kPa, (346.13±42.63) dyn? s/cm5 vs (241.68±50.21) dyn? s/cm5, (21.47± 3.85) V/(cml? s) vs (11.24 ± 3.67) V/(cml? s);t =5.8954, 4.2589,4.8792,6.3985,6.3874,6.9852,5.6387,4.6892,6.0387,4.8562, 11.475,8.041,12.422, 11.820, 12.854,20.412;P＜0.01).Conclusion The function of automatic adjustment shows obvious abnormal cerebral blood flow in patients with hypertension, andthe TCD technology can response of cerebral blood flow autoregulation,which has important clinical value for diagnosis and treatment of cerebral infarction, stroke and other cardiovascular and cerebrovascular diseases.
RESUMO
BACKGROUND: The basilar artery (BA) may act as an important intracranial collateral to supply hypoperfused anterior circulation. We examined the basilar reserve capacity by using transcranial Doppler sonography (TCD) in patients with occlusive vascular diseases in the anterior circulation (OAC) to determine whether vasomotor reactivity (VMR) of the BA can be affected by the presence of OAC. METHODS: Twenty-five patients were given an MRI including an MRA for minor ischemic symptoms, headache, or dizziness and were divided into two groups according to the presence of OAC. The OAC included occlusions of either the internal carotid artery (ICA) or M1 segment of the middle cerebral artery (MCA). The VMR to hypercapnea was calculated by means of the breath-holding index (BHI). We compared the VMR of the BA between those with and without OAC. RESULTS: Patients with OAC (n=8) showed significantly reduced basilar VMR, compared to that of patients without OAC (n=17) (0.57+/-0.49 versus 1.36+/-0.47, P=0.001). The baseline mean flow velocity of BA was also higher in patients with OAC (70.6+/-24.2cm/s) than those without (38.8+/-11.5 cm/s). However, the baseline pulsatility index did not show differences between patients with and without OAC. CONCLUSIONS: Patients with OAC showed decreased VMR of BA, which can be an easily applicable and useful TCD index for assessing the hemodynamic status in patients with OAC.