Müllges W, Berg D, Toyka K V
Department of Neurology, Julius Maximilians University Hospital, Würzburg, Germany.
Ultrasound Med Biol. 1999 Jun;25(5):755-8. doi: 10.1016/s0301-5629(99)00032-0.
Microembolism generated during extracorporeal circulation is thought to be responsible for stroke and neuropsychological deficits. Before one can investigate the pathogenetic role in more detail, reproducible and reliable quantitative methods need to be developed. In several previous studies, microemboli detection was performed unilaterally. We questioned if this reflects the bihemispheric embolic load. In 42 patients undergoing coronary artery bypass grafting, bilateral embolus detection was performed during extracorporeal circulation. The side-to-side correlation of microembolus counts was strong (0.91), but there was a significant difference in number (p < 0.01) comparing left and right emboli. The side of higher embolus counts cannot be predicted in the individual because either side may show higher counts. Doubling the unilateral count may deviate from the bilateral count by as much as 51% in the individual patient. The total embolic load to the brain during extracorporeal circulation cannot be precisely predicted from unilateral transcranial insonation alone.
体外循环过程中产生的微栓塞被认为是导致中风和神经心理缺陷的原因。在能够更详细地研究其发病机制作用之前，需要开发可重复且可靠的定量方法。在先前的几项研究中，微栓子检测是单侧进行的。我们质疑这是否反映了双侧的栓塞负荷。在42例接受冠状动脉搭桥手术的患者中，体外循环期间进行了双侧栓子检测。微栓子计数的左右相关性很强（0.91），但左右栓子数量存在显著差异（p < 0.01）。个体中栓子计数较高的一侧无法预测，因为两侧都可能显示较高的计数。在个体患者中，将单侧计数翻倍可能与双侧计数相差多达51%。仅通过单侧经颅超声检查无法精确预测体外循环期间大脑的总栓塞负荷。
