Reseach Of Cerebral Vascular Reserve Function Of Middle Cerebral Artery Tenosis Patients By TCD Combined With ETCO₂

Objective: The method transcranial Dopple（TCD） and end-tidal carbon dioxide partialpressure （ETCO₂） was used to investigate the cerebrovascular reserve capacity and collateralcirculation with middle cerebral artery stenosis patients, to explore and discuss thediagnostic value in severe stenosis or occlusion of MCA. To explore the diagnostic standardof leptomeningeal collateral channels opening.To determine the incidence rate and theinfluencing fators of asymptomatic and symptomatic MCA stenosis.Methods: The98cases were enrolled in this study, include of59patients with one or twomiddle cerebral artery stenosis and39normal persons.All the patients were routinelyexamined with TCD and ETCO₂TEST。According to the symptoms and signs of patientsandMRA/MRI。The31cases of asymptomatic MCA stenosis were enrolled.The28cases ofsymptomatic MCA stenosis were enrolled。According to the symptoms and signs of patientsand TCD。The33cases of severe stenosis or occlusion of MCA were enrolled.The15cases ofmiddle stenosis of MCA were enrolled。The11cases of mild stenosis of MCA were enrolled。The specificity and sensitivity of two standards in LMCs opening of ACA and PCA werejudged with TCD.LMCs opening ratio in patients with occulusion of MCA was higher thanthat in normal persons, the sensitivity and specificity of ACA collateral circulation judged byivACA＞cvMCA.The sensitivity and specificity of PCA collateral circulation judged byivPCA＞1.3cvPCA.The relationship between LMCs opening of ACA and PCA in patientswith severe stenosis or occlusion of MCA and risk factors of cerebral vascular disease werestatistically analyzed.Results: The cerebrovascular reserve capacity of one or two middle cerebral artery stenosissignificantly decrease than normal control group.LMCs opening ratio in patients with severestenosis or occulusion of MCA was higher than that in normal persons and mild stenosis ormiddle cerebral artery stenosis of MCA.LMCs opening ratio in patients with middle cerebralartery stenosis of MCA is higher than mild stenosis of MCA.The cerebrovascular reservecapacity of patients with asymptomatic MCA stenosis and symptomatic MCA stenosis issignificantly decrease than normal control group.The cerebrovascular reserve capacity ofmild stenosis of MCA is higher1`than middle cerebral artery stenosis and severe stenosis or occulusion of MCA.Conclusions:（1）:The capacity of cerebrovascular reserve was reduced in patients with intracranial arterystenonsis than normal control group.（2）:LMCs opening ratio in patients with severe stenosis or occulusion of MCA was higherthan that in normal persons。The situation of opening of the collateral branches of MCA afterdesease can be judged indirectly withTCD.（3）: The cerebrovascular reserve capacity of patients with asymptomatic MCA stenosis andsymptomatic MCA stenosis is significantly decrease than normal control group.