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[目的]探讨经颅多普勒超声(TCD)对高血压与糖尿病诱发的脑血管狭窄的诊断意义。[方法]对合并高血压和/或糖尿病的确诊为脑血管病的122例患者进行TCD检查,并与数字减影血管造影(DSA)比较,观察颅内血管的变化情况。[结果]共检查血管1025根,TCD发现狭窄血管165根,其中129根与DSA诊断一致,但在TCD检查正常的血管中DSA发现血管狭窄16根,提示TCD检查的敏感性为81.2%,特异性为93.6%,阴性预测值为95.3%,阳性预测值为72.7%。其中对大脑中动脉的价值最大,其后依次为椎动脉、大脑前后动脉。同时合并高血压与糖尿病患者的血管狭窄率明显升高。[结论]TCD对诊断脑血管狭窄具有较高的敏感性和特异性,尤其对大脑中动脉和椎动脉,对大脑前动脉和大脑后动脉诊断须慎重。
[Objective] To investigate the diagnostic significance of transcranial Doppler ultrasound (TCD) on hypertension and diabetes-induced cerebrovascular stenosis. [Methods] TCD was performed in 122 patients with hypertension and / or diabetes diagnosed with cerebrovascular disease and compared with digital subtraction angiography (DSA) to observe the changes of intracranial blood vessels. [Results] A total of 1025 blood vessels were examined, 165 of which were found by TCD. 129 of them were consistent with the diagnosis of DSA. However, there were 16 vascular stenosis in DSA with normal TCD examination, suggesting a sensitivity of 81.2% for TCD examination The sex was 93.6%, the negative predictive value was 95.3%, and the positive predictive value was 72.7%. One of the largest value of the middle cerebral artery, followed by the vertebral artery, anterior cerebral artery. At the same time, hypertension and diabetes mellitus patients with vascular stenosis rate was significantly increased. [Conclusion] TCD has high sensitivity and specificity for the diagnosis of cerebral vascular stenosis. Especially for the middle cerebral artery and vertebral artery, the diagnosis of anterior cerebral artery and posterior cerebral artery should be carefully considered.