中国卒中杂志2017，Vol.12Issue(9)：781-785,5.DOI:10.3969/j.issn.1673-5765.2017.09.004
经颅多普勒预测高改良Fisher分级蛛网膜下腔出血后迟发性脑缺血研究
Study on Transcranial Doppler in Predicting Delayed Cerebral Ischemia after Subarachnoid Hemorrhage with Higher Modified Fisher Grade
吴建维 1郭军平 1贾娇坤 1丁则昱 1杨中华 1赵性泉1
作者信息
- 1. 100050 北京 首都医科大学附属北京天坛医院神经病学中心,国家神经系统疾病临床医学研究中心,脑血管病转化医学北京市重点实验室
- 折叠
摘要
Abstract
Objective To investigate whether the predictive reliability of an increase in the mean blood flow velocity ratio of the ipsilateral to contralateral middle cerebral arteries (I/C mBFV) ≥120 cm/s is higher than that of the conventional absolute flow velocity (mBFV) for delayed cerebral ischemia (DCI) in higher modified Fisher grade. Methods Patients admitted into NICU of Beijing Tiantan Hospital, Capital Medical University from November 2011 to November 2013 who underwent transcranial Doppler sonography (TCD) and diagnosed with subarachnoid hemorrhage (SAH) ≥3 by modified Fisher grade were consecutively enrolled into study retrospectively. The mBFV value in bilateral middle cerebral arteries and I/C mBFV were recorded. The end point was delayed cerebral ischemia (DCI). The I/C mBFV and middle cerebral artery mBFV ≥120 cm/s were calculated for predicting the sensitivity, specificity, positive predictive value and negative predictive value of DCI. Results A total of 44 patients were included in the study, among which, 18 patients developed DCI, with incidence rate of 41％. For middle cerebral artery mBFV ≥120 cm/s, the sensitivity, specificity, positive predictive value and negative predictive value of TCD in predicting DCI were 77.8％, 50％,53.8％, 75％, respectly. For I/C mBFV ≥1.5, the sensitivity, specificity, positive predictive value and negative predictive value of TCD in predicting DCI were 71.8％, 41.7％, 50％, 71.4％, respectively. Conclusion For SAH patients with higher modified Fisher grade, TCD was still an important tool for predicting DCI. The predictive value of mBFV ≥120 cm/s was higher than that of I/C mBFV≥1.5.关键词
血流速度/脑血管痉挛/迟发性脑缺血/蛛网膜下腔出血/经颅多普勒Key words
Blood flow velocity/Cerebral vasospasm/Delayed cerebral ischemia/Subarachnoid hemorrhage/Transcranial Doppler引用本文复制引用
吴建维,郭军平,贾娇坤,丁则昱,杨中华,赵性泉..经颅多普勒预测高改良Fisher分级蛛网膜下腔出血后迟发性脑缺血研究[J].中国卒中杂志,2017,12(9):781-785,5.
