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目的 探讨从正常人至脑卒中发病前后不同时期脑血管血液动力学指标 (CVHI)的变化规律和特征。方法 研究对象选自东北、华北等地区 35岁及以上 2 5 355例脑血管病研究队列人群 ,55例急性期脑卒中患者选自南京军区福州总医院。CVHI检测为基线调查或脑卒中发病 1周内的检测结果。将研究对象分成正常人群、高危人群、脑卒中前超高危个体以及脑卒中急性期和恢复期患者等 5组。比较分析各组人群的CVHI变化规律。结果 上述 5组人群的脑血管最小血流速度 (Vmin)均值依次为 1 1 .39± 3 .2 7、9.66± 3 .1 8、6 .71± 3 .30、4 .1 3± 1 .2 7、6 .78± 3 .0 9;平均血流速度 (Vmean)和最大血流速度 (Vmax)为依次降低的变化趋势 ;而外周阻力 (RV)依次为 62 .35± 2 1 .1 1、82 .32± 31 .1 6、1 2 2 .72± 52 .73、1 37.46± 49.56、1 1 5 .89± 55 .51 ,特性阻抗 (Zcv)、脉搏波波速 (WV)、动态阻力 (DR)和临界压 (CP)等指标为依次升高的趋势。 5组CVHI积分的异常 (<75分 )发生率分别为 1 3 .3 %、34 .7%、74.1 %、1 0 0 %和 66 .7%。结论 从正常人到脑卒中高危人群及脑卒中发病的不同临床阶段 ,脑血管血流速度呈现下降趋势 ,外周阻力等指标呈上升趋势。
Objective To investigate the changes and characteristics of cerebrovascular hemodynamics (CVHI) at different periods before and after the onset of stroke from normal subjects. Methods Subjects were selected from a cohort of 3555 cerebral vascular disease patients aged 35 years and older in Northeast China and North China, and 55 cases of acute stroke patients were selected from Fuzhou General Hospital of Nanjing Military Area Command. CVHI test as a baseline survey or stroke within 1 week of the test results. Subjects were divided into five groups: normal population, high-risk population, pre-stroke individuals with ultra-high risk and acute and convalescent stroke. Comparative analysis of CVHI changes in all groups. Results The average blood flow velocity (Vmin) of cerebrovascular in the above 5 groups was 11.39 ± 3.27, 7.66 ± 3.18, 6.71 ± 3.30, 4.13 ± 1. 2 7,6 .78 ± 3 .0 9; Vmean and Vmax decreased in a sequential order; and the peripheral resistance (RV) was 62.35 ± 21.1 1,82 .32 ± 31 .1 6,1 2 2 .72 ± 52 .73,1 37.46 ± 49.56,1 15.89 ± 55 .51, Zcv, WV, Resistance (DR) and critical pressure (CP) and other indicators for the order of increasing trend. The incidence of abnormal CVHI scores (<75 points) in the 5 groups were 13.3%, 34.7%, 74.1%, 100% and 66.7%, respectively. Conclusions From normal subjects to high-risk stroke patients and different clinical stages of stroke, cerebrovascular blood flow velocity shows a downward trend and peripheral resistance indicators show an upward trend.