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目的:探讨症状性椎基底动脉狭窄患者后循环中微栓子监测的临床价值。方法:收集本院神经内科住院的75例急性缺血性中风合并椎基底动脉狭窄患者进行经颅多普勒(TCD)检查及脑微栓子检测,随访观察数据之间行配对t检验。结果:75例患者中MES阳性13例,阳性率17.3%,中高度狭窄组患者阳性率明显高于轻度狭窄患者(25.0%vs6.5%,P<0.05);抗栓治疗后MES明显减少;73例患者随访,12例(12/73,16.4%)缺血性中风再发,MES阳性缺血性中风复发率高于MES阴性组(38.5%vs11.7%,P<0.05)。结论:可以通过大脑后动脉(posterior cerebralartery,PCA)和基底动脉(basilarartery,BA)进行微栓子监测,评价抗栓治疗的疗效,中高度狭窄的椎基底动脉更易出现后循环的MES;后循环MES阳性的患者易复发脑卒中。
Objective: To investigate the clinical value of microemboli monitoring in patients with symptomatic vertebrobasilar artery stenosis. Methods: 75 patients with acute ischemic stroke and vertebro-basilar artery stenosis were enrolled in our hospital for neurosurgery. Transcranial Doppler (TCD) and cerebral microembolization were performed in patients with acute ischemic stroke and follow-up observation. Results: The positive rate of MES in 75 cases was 17.3%. The positive rate of MES was significantly higher in patients with moderate and severe stenosis than in patients with mild stenosis (25.0% vs 6.5%, P <0.05). The MES was significantly decreased after antithrombotic therapy ; 73 patients were followed up, 12 (12 / 73,16.4%) ischemic stroke recurrence, MES-positive ischemic stroke recurrence rate was higher than MES negative group (38.5% vs11.7%, P <0.05). CONCLUSIONS: The effect of antithrombotic therapy can be evaluated by monitoring microemboli through the posterior cerebralartery (PCA) and basilar artery (BA), and the posterior circulation MES is more likely to occur in the mid-stenotic vertebrobasilar artery MES-positive patients are prone to recurrent stroke.