经颅多普勒与脑电地形图检测对TIA临床诊断的价值(1)
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[摘要] 目的：探讨经颅多普勒(TCD)与脑电地形图(BEAM)检测对短暂性脑缺血发作(transient ischemic attack，TIA)临床诊断的价值。方法：对13例TIA患者行TCD及脑电地形图检测，并对结果进行回顾性分析。结果：TCD表现单根或多根血管血流速度增快5例，减慢6例，脑动脉硬化9例，正常2例。BEAM表现α频段功率减低7例，θ频段功率异常增高4例，正常2例。TCD 与脑电地形图阳性率均为84.6%，且两者有交叉互补性。结论：TCD与脑电地形图检测对TIA临床诊断有重要意义，两者有互补性。
[关键词] 经颅多普勒；脑电地形图；短暂性脑缺血发作
[中图分类号] R743.31；R445 [文献标识码] B [文章编号] 1673-7210(2010)10(b)-067-02
The value of TCD and BEAM in diagnosis of TIA
JIA Guowei1, TANG Songtao2, FENG Jing1, XIE Xianzhang1
(1.Department of Function, the Community Health Services Center of Dongguan Liaobu in Guangdong Province, Dongguan 523400, China; 2. Department of Internal Medicine, the Liaobu Hospital of Dongguan City in Guangdong Province, Dongguan 523400, China)
[Abstract] Objective: To discuss the value of transcranial Doppler(TCD) and brain eletrical activity mapping(BEAM) in diagnosis of transient ischemic attack(TIA). Methods: Thirteen cases with TIA diagnosed by TCD and BEAM were analyzed retrospectively. Results: TCD showed that blood flow velocity rised up in 5 cases and 6 cases reduced, 9 cases showed cerebral arteriosclerosis and 2 cases normal. BEAM showed α frequency band power reducing in 7 cases, 2 cases normal and with 4 cases θ frequency band power increasing singularly. The diagnostic rate of TCD and BEAM both were 84.6%, TCD and BEAM both were crossing and complementary each other. Conclusion: TCD and BEAM are of use for diagnosis ofTIA, TCD and BEAM both are of complement each other.
[Key words] Transcranial Doppler; Brain eletrical activity mapping; Transient ischemic attack
短暂性脑缺血发作(transient ischemic attack，TIA)是指颈内动脉或椎-基底动脉系统短暂性血液供应不足。TIA是脑梗死的先兆，应予以高度重视。TIA是由供脑血管病变引起的一过性或短暂性局灶性脑或视网膜功能障碍，临床症状在24 h内完全消失，不遗留神经功能缺损症状和体征[1]。
1 资料与方法
1.1 一般资料
笔者自2008年3月～2010年6月共对13例临床拟诊为TIA，CT检查未见明显异常的患者行TCD与脑电地形图检测。其中男性6例，女性7例；年龄38～75岁；4例有高血压病史。临床表现8例一过性眩晕，2例一过性偏瘫，3例一过性失语。
1.2 检查方法
使用EMS-9000经颅多普勒仪，探头频率2 Hz，仰卧位，颞窗探查双侧大脑中动脉、大脑前动脉、大脑后动脉。俯卧位，经枕窗检查椎动脉、基底动脉。使用KT88-4型16导脑电地形图仪。
2 结果
本组病例TCD与BEAM具体表现及例数见表1。
从表1中可见，TCD表现单根或多根血管血流速度增快5例，减慢6例；脑动脉硬化9例，正常2例。BEAM表现α频段功率减低7例，θ频段功率异常增高4例，正常2例。TCD检查阳性率为84.6%，BEAM检查阳性率为84.6%，两者共同利用阳性率为92.3%，两者有互补性。1例TCD正常的患者BEAM显示异常，1例BEAM正常的患者TCD异常，1例患者两者均显示正常，无诊断意义。
3 讨论
3.1 TIA的诊断需符合下列诊断要点
①发病突然；②具有局灶性脑或视网膜功能障碍的症状；③持续时间短暂 ......
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