硝酸甘油药物试验在脑血管疾病中的应用(1)
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[摘要] 目的:探讨硝酸甘油(nitroglycerin,NG)药物试验在脑血管疾病中的应用。方法:用经颅多普勒超声技术(transcranial Doppler ultrasound,TCD)连续观察脑血管的代偿能力,明确病变性质及其程度。对50例健康人(Ⅰ组)和110例患者组(Ⅱ组、Ⅲ组)的脑底动脉血流速度及频谱形态进行分析评价。结果:1 min时Ⅱ、Ⅲ组脑血流速度普遍高于Ⅰ组,2 min后血流速度开始减慢;且血流速度到达最低值的时间快于Ⅰ组,并分别与Ⅰ组进行比较,差异有统计学意义(P<0.05)。Ⅰ组血流频谱在舌下含化NG 1 min后即发生改变;Ⅱ组在2 min后发生改变,多在4～5 min内变为陡直型;但Ⅲ组5 min内未见频谱改变。结论:此药物试验不仅反映脑血液循环及脑血管的病变程度,还可区分功能性血管弹性减退及器质性的脑动脉硬化。
[关键词] 经颅多普勒超声;硝酸甘油;血流速度;血流频谱;高血压Ⅰ期;脑动脉硬化
[中图分类号] R743.1[文献标识码]A [文章编号]1673-7210(2010)06(c)-005-03
The application of nitroglycerin in cerebrovascular diseases
LIU Jiying, HOU Jun, AN Peng
(Qingdao Municipal Hospital, Qingdao 266011, China)
[Abstract] Objective: To investigate the use of nitroglycerin (NG) in cerebrovascular diseases. Methods: The blood flow speed and spectra appearance in the arteries of base of skull obtained by using transcranial Doppler ultrasound (TCD) of the 50 controls (groupⅠ) and 110 patients (groupⅡ group Ⅲ) with vascular headache were continuously analyzed. Results: 1 minutes after administration of nitroglycerin blood flow speed was faster in group Ⅱ and Ⅲ than groupⅠ, but 2 minutes later, the blood flow speed slowed down in group Ⅱ and Ⅲ. The duration to the lowest blood flow speed in groups Ⅱ and Ⅲ was shorter than groupⅠ(P<0.05). The spectra appearance in groupⅠ had changed 1 minute after sublingual administration of nitroglycerin and began to change in hypertension (group Ⅱ) after 2 minutes. The atherosclerosis (group Ⅲ) did not change in 5 minutes. Conclusion: This drug test can distinguish functional blood vessel elasticity decrease from organic cerebral arteriosclerosis.
[Key words] Transcranial Doppler ultrasound; Nitroglycerin; Blood flow speed; Spectra appearance of blood flow; Hypertension stage Ⅰ; Cerebral arteriosclerosis
人体的脑血管具有一定的代偿功能,在某些脑血管疾病特别是早期阶段,可能没有表现出明显的脑血液循环障碍。因此,常规经颅多普勒超声(transcranial Doppler ultrasound,TCD)检查有时不能完全反映脑循环和脑血管的病变程度,而频谱形态也难以区分脑血管功能性与器质性弹性减退。为提高TCD的诊断价值,本研究采用舌下含化硝酸甘油(nitroglycerin,NG)连续观察在药物作用下的TCD变化,以了解脑血管血流速度及频谱形态的改变,明确脑血管的代偿能力、病变性质及程度,对判断脑动脉硬化程度有重要意义 ......
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