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经颅多普勒超声诊断蛛网膜下腔出血后脑血管痉挛:与患者年龄相关的结果相关性及分析

Transcranial Doppler diagnosis of cerebral vasospasm following subarachnoid haemorrhage: correlation and analysis of results in relation to the age of patients.

作者信息

Boecher-Schwarz H G, Ungersboeck K, Ulrich P, Fries G, Wild A, Perneczky A

机构信息

Department of Neurosurgery, Johannes Gutenberg University of Mainz, Federal Republic of Germany.

出版信息

Acta Neurochir (Wien). 1994;127(1-2):32-6. doi: 10.1007/BF01808543.

Abstract

A retrospective analysis was undertaken to determine whether cerebral vasospasm following subarachnoid haemorrhage (SAH) correlates with the age of patients. For at least 3 weeks after bleeding 80 subjects underwent very close follow-up with clinical examination and transcranial Doppler records of the blood velocities within the basal cerebral arteries. Firstly a correlation between measured maximal mean blood flow velocities and age was made. Secondly, according to their age and the maximum of recorded mean velocities (v), the patients were divided into groups as follows: age 55 years or less, age more than 55 years; and maximum velocity v1 < 90 cm/s, 90 cm/s < v2 < 120 cm/s, 120 cm/s < v3 < 160 cm/s, v4 > 160 cm/s. There was a significant correlation of the measured maximum mean velocities and the age of the patients (r = -0.525, p < 0.01). With regard to the velocity groups there was a significant (chi-squared statistic for contingency tables, p < 0.01) difference between both age-groups: 32% (n = 18) of the younger fell into group v4 with maximum mean velocities of more than 160 cm/s, but none of the older had such. Vice versa, 63% (n = 15) of the older compared with only 14% (n = 8) of the younger fell into group v1 with maximum mean velocities of less than 90 cm/s. Clinical follow-up also depicted differences between both age groups. 13 of 18 younger patients with maximum mean velocities > 160 cm/s exhibited symptomatic vasospasm with a delayed neurological deficit. This typical course did not occur in the older age group.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

进行了一项回顾性分析,以确定蛛网膜下腔出血(SAH)后的脑血管痉挛是否与患者年龄相关。在出血后至少3周内,80名受试者接受了密切随访,包括临床检查和基底脑动脉内血流速度的经颅多普勒记录。首先,测量的最大平均血流速度与年龄之间进行了相关性分析。其次,根据患者年龄和记录的平均速度最大值(v),将患者分为以下几组:55岁及以下,55岁以上;最大速度v1 < 90 cm/s,90 cm/s < v2 < 120 cm/s,120 cm/s < v3 < 160 cm/s,v4 > 160 cm/s。测量的最大平均速度与患者年龄之间存在显著相关性(r = -0.525,p < 0.01)。关于速度分组,两个年龄组之间存在显著差异(列联表卡方统计量,p < 0.01):较年轻组中32%(n = 18)属于v4组,最大平均速度超过160 cm/s,但较年长组中无人如此。反之,较年长组中63%(n = 15)属于v1组,最大平均速度小于90 cm/s,而较年轻组中只有14%(n = 8)如此。临床随访也显示了两个年龄组之间的差异。18名最大平均速度> 160 cm/s的较年轻患者中有13名出现了有症状的血管痉挛并伴有延迟性神经功能缺损。这种典型病程在较年长组中未出现。(摘要截断于250字)

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