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纸质出版:2014
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夏坤伟,陈礼刚,张苓,孟桃.经颅多普勒超声联合血小板计数对外伤后脑梗死发生的预测作用[J].陆军军医大学学报(原第三军医大学学报),2014,36(16):1746-1749.
Xia Kunwei,Chen Ligang,Zhang Ling,Meng Tao.Predictive effect of transcranial Doppler ultrasonography combined with platelet counting for posttraumatic cerebral infarction[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(16):1746-1749.
夏坤伟,陈礼刚,张苓,孟桃.经颅多普勒超声联合血小板计数对外伤后脑梗死发生的预测作用[J].陆军军医大学学报(原第三军医大学学报),2014,36(16):1746-1749. DOI:
Xia Kunwei,Chen Ligang,Zhang Ling,Meng Tao.Predictive effect of transcranial Doppler ultrasonography combined with platelet counting for posttraumatic cerebral infarction[J].J Amry Med Univ (J Third Mil Med Univ),2014,36(16):1746-1749. DOI:
目的 探讨颅脑损伤后大脑中动脉平均血流速度(V
m
MCA)、肘静脉血小板计数(PLT计数)与外伤性脑梗死发生的关系。 方法 回顾分析2010年6月至2012年1月符合纳入标准的颅脑损伤保守治疗患者387例临床资料,包括患者伤后1、2、3、5、7 d和14 d对患者行TCD检查测量所得的V
m
MCA值,同时采集患者肘静脉血测量所得的PLT计数,伤后24 h患者格拉斯哥昏迷评分(GCS评分)分值。将伤后治疗过程中14 d内发生脑梗死的患者列为梗塞组,14 d内未出现脑梗死者列为对照组。如果梗塞组患者于14 d内某时刻出现了脑梗死则将不再继续测量比较,剩余患者(最终在14 d内某时刻均已发生脑梗死)继续与对照组进行比较。回顾性研究梗塞组、对照组患者入院后14 d内各时段(1、2、3、5、7 d和14 d)测量所得的V
m
MCA、PLT计数,分析外伤性脑梗死(posttraumatic cerebral infarction,PTCI)与伤后各时段V
m
MCA、PLT计数之间的关系,研究两者及两者结合对外伤性脑梗死发生的预测作用,以及伤后第1天V
m
MCA、PLT计数与伤情严重程度(GCS评分)关系。 结果 梗塞组V
m
MCA较对照组快(Z=-5.302,
P
0.01),梗塞组PLT计数较对照组低(Z=-6.702,
P
0.01),伤后第1天的V
m
MCA值越高,PLT计数越低,GCS越低
伤情越重。 结论 颅脑损伤后V
m
MCA增高、PLT计数降低与伤后脑梗死的发生有一定的联系,将两者联合对外伤后脑梗死的发生有早期预测作用,伤后1 d V
m
MCA、PLT计数对伤情严重程度有评估作用。
Objective To explore the relationship of average middle cerebral artery blood flow velocity (V
m
MCA) and elbow vein blood platelet (PLT) count with incidence of possttraumatic cerebral infarction (PTCI).
Methods We performed a retrospective analysis with the standard clinical data of 387 patients having craniocerebral injury and conservative treatment from June 2010 to January 2012
including V
m
MCA values of transcranial Doppler ultrasonography (TCD) examination and venous blood PLT count at 1
2
3
5
7 and 14 d after injury as well as a Glasgow coma scale (GCS) score 24 h after injury. The patients who suffered from cerebral infarction within 14 d were divided into an infarction group
and the patients who did not suffer from cerebral infarction within 14 d into a control group. In the infarction group
the patients suffering from cerebral infarction were rejected on measurement
and the remaining patients were compared with the control patients. The relationship of PTCI with V
m
MCA and PLT count at 1
2
3
5
7 and 14 d after injury was analyzed. The relationship of the GCS score with V
m
MCA and PLT count at 1 d after injury was also analyzed. Results V
m
MCA of the infarction group was higher than that of the control group at each time point (Z=-5.302
P
0.01)
while the PLT count of the infarction group was lower (Z=-6.702
P
0.01). One day after injury
higher V
m
MCA value was accompanied by lower PLT count
lower GCS score
and more serious injury degree. Conclusion The increase of V
m
MCA and decrease of PLT count after injury have relationship with the occurrence of PTCI. Combining V
m
MCA and PLT count has an early prediction effect for posttraumatic cerebral infarction. The V
m
MCA and PLT count 1 d after injury are useful for prediction of the injury severity.
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