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目的:观察结核性脑膜炎的脑血流动力学变化特点,探讨TCD检测在判断其病情严重程度和临床预后的应用价值.资料与方法:20例结核性脑膜炎,30例健康者,用ZMHz探头检测ACA、MCA、PCA、BA、VA的Vs、Vd、Vm、PI值及频谱形态.根据病人人院时意识状况按GCS评分分组,预后按COS分级,并与ACA、MCA的血流动力学指标进行相关分析.结果:ACA、MCA、VA、BA血流速度增快;所测动脉PI值均升高.CCS3-8分:ACA、MCA流速显著增快,MCA-PI值升高.GCS9-13分:ACA、MCA流速增快,PI值升高;GCS14—15分:MCA血流明显减慢.相关分析结果ACA-Vs、-Vd、-Vm和MCA-Vs与GCS、GOS均成负相关;MCA-PI值与GOS成负相关.结论:结核性脑膜炎异常改变广泛,波及颈内动脉系统和椎-基底动脉系
Objective: To observe the characteristics of cerebrovascular hemodynamic changes of tuberculous meningitis and to explore the value of TCD in judging the severity of the disease and clinical prognosis.Materials and Methods: 20 cases of tuberculous meningitis and 30 healthy persons were treated with ZMHz The Vs, Vd, Vm, PI and spectral features of ACA, MCA, PCA, BA and VA were detected by the probe.According to the patient’s consciousness during hospitalization, the patients were grouped according to the GCS score and the prognosis was graded according to COS and compared with ACA, MCA hemodynamic The results showed that the blood flow velocity of ACA, MCA, VA, BA increased rapidly and the PI value of the measured artery increased.CCS3-8: ACA, MCA flow rate increased significantly, MCA-PI value increased. GCS9-13 points: ACA, MCA velocity increased, PI value increased; GCS14-15 points: MCA blood flow was significantly slowed down.Correlation analysis results ACA-Vs, -Vd, -Vm and MCA-Vs and GCS, GOS And negative correlation between MCA-PI and GOS.Conclusions: The abnormal changes of tuberculous meningitis are widespread and affect the internal carotid artery system and vertebrobasilar artery system