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目的明确糖尿病对颈内动脉狭窄或闭塞患者脑血流自动调节功能及6个月内新发心脑血管事件发病几率的影响。方法单侧颈内动脉狭窄或闭塞患者60例,分为糖尿病组(30例)和非糖尿病组(30例),对照组30例。应用经颅多普勒(transcranial Doppler,TCD)结合主动体位改变的方法监测狭窄侧大脑中动脉平均脑血流速度变化(changes of mean cerebral blood flow velocity,△MCBFV)。结果糖尿病组的△MCBFV显著低于对照组及非糖尿病组[糖尿病组(17.67±7.78)%,非糖尿病组(11.83±6.38)%,对照组(3.54±3.32)%,P<0.001)]。糖尿病组6个月内发生短暂性脑缺血发作2例,非糖尿病组1例。结论糖尿病组患者脑血流自动调节功能更差,且其6个月内新发脑血管事件的风险有增高的趋势。
Objective To investigate the effect of diabetes on cerebral blood flow auto-regulation in patients with internal carotid artery stenosis or occlusion and the incidence of new cardiovascular and cerebrovascular events within 6 months. Methods Sixty patients with unilateral carotid artery stenosis or occlusion were divided into diabetic group (30 cases) and non-diabetic group (30 cases), and control group (30 cases). The changes of mean cerebral blood flow velocity (△ MCBFV) in the stenosed side of the stenosis were monitored by transcranial Doppler (TCD) combined with the change of active position. Results △ △ MCBFV in diabetic group was significantly lower than that in control group and non-diabetic group [diabetic group (17.67 ± 7.78)%, non-diabetic group (11.83 ± 6.38)%, control group (3.54 ± 3.32)%, P <0.001). There were 2 cases of transient ischemic attack within 6 months in diabetic group and 1 case in non-diabetic group. Conclusion The auto-regulation of cerebral blood flow in patients with diabetes mellitus is even worse, and the risk of new-onset cerebrovascular events tends to increase in 6 months.