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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Increased Pulsatility of the Intracranial Blood Flow Spectral Waveform on Transcranial Doppler Does Not Point to Peripheral Arterial Disease in Stroke Patients
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Increased Pulsatility of the Intracranial Blood Flow Spectral Waveform on Transcranial Doppler Does Not Point to Peripheral Arterial Disease in Stroke Patients

机译：经颅多普勒对颅内血流频谱波形增加搏动不指向中风患者的外周动脉疾病。

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Background: Peripheral arterial disease (PAD) is common in patients with acute cerebral ischemia. Indexes of resistance derived from the systolic and diastolic velocities are routinely used in diagnostic transcranial Doppler (TCD) to detect intracranial arterial disease. We sought to explore whether these indexes can predict the presence of PAD in acute cerebral ischemia. Methods: We prospectively evaluated consecutive patients with acute cerebral ischemia. On TCD, peak-systolic and end-diastolic velocities in both middle cerebral and basilar arteries were manually measured to calculate pulsatility index (PI) and resistance index (RI). Increased resistance was defined as PI equal to 1.2 or more and RI equal to .75 or more. Ankle-brachial index (ABI) measurements were performed and an ABI equal to .9 or more was considered predictive of definite PAD. Results: We included 95 patients (45 male, 50 female) aged 66 6 9 years with a median National Institutes Health Stroke Scale score of 3 (interquartile range, 8) points. The ABI was abnormal and consistent with definite PAD in 24 of 95 (25.3%; 95% confidence interval [ CI], 16.4-4.2) patients. Increased PI did not differ among patients with and without PAD (20.8% vs. 28.2%, P =.60). Only 1 patient with PAD had increased RI as opposed to 4 patients without PAD (4.2% vs. 5.6%, P = 1.0). Increased PI was not found to be an independent predictor of PAD (odds ratio [ OR],.68; 95% CI,.22-2.12; P =.51). Increases in both PI and RI independently predicted arterial hypertension (OR, 1.62; 95% CI, 1.19-2.21; P =.002 and OR, 3.20; 95% CI, 1.51-6.77; P=.002, respectively). Conclusions: Our findings indicate that PAD cannot be inferred from intracranial flow parameters predictive of arterial disease and risk factors such as hypertension among patients with acute cerebral ischemia. Key Words: Stroke-peripheral arterial disease-intracranial disease-transcranial Doppler. (C) 2015 by National Stroke Association
机译：背景：周围性动脉疾病（PAD）在急性脑缺血患者中很常见。诊断性经颅多普勒（TCD）通常使用源自收缩和舒张速度的抵抗指数来检测颅内动脉疾病。我们试图探讨这些指标是否可以预测急性脑缺血中PAD的存在。方法：我们前瞻性评估了连续性急性脑缺血患者。在TCD上，手动测量大脑中动脉和基底动脉的收缩期和舒张末期速度，以计​​算搏动指数（PI）和阻力指数（RI）。电阻增加定义为PI等于1.2或更大，RI等于0.75或更大。进行踝肱指数（ABI）测量，且等于或大于0.9的ABI被认为可预测明确的PAD。结果：我们纳入了95名患者（45名男性，50名女性），年龄66 6 9岁，美国国立卫生研究院健康卒中量表评分中位数为3（四分位间距为8）分。 95例患者中有24例（25.3％; 95％置信区间[CI]，16.4-4.2）中的ABI异常且与明确的PAD相符。有和没有PAD的患者中PI的增加无差异（20.8％对28.2％，P = .60）。只有1名PAD患者的RI升高，而4名无PAD的患者（4.2％vs. 5.6％，P = 1.0）。没有发现PI升高是PAD的独立预测因子（几率[OR]为0.68; 95％CI为0.22-2.12; P = 0.51）。 PI和RI的升高独立预测动脉高血压（分别为OR，1.62; 95％CI，1.19-2.21; P = .002和OR，3.20; 95％CI，1.51-6.77; P = .002）。结论：我们的发现表明，急性脑缺血患者不能通过预测动脉疾病和危险因素（例如高血压）的颅内流量参数来推断PAD。关键词：中风-外周动脉疾病-颅内疾病-经颅多普勒。 （C）国家卒中协会2015年

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