The Study Of Transcranial Doppler Sonography Detect Cerebral Vascular Reactivity In The Patients Of Carotid Artery Stenosis

Objective:The purpose of the present study was to evaluate the relationships among carotid artery stenosis and Cerebral vascular reactivity, Through Transcranial Doppler detect Cerebral vascular reactivity in the patients of carotid artery stenosis, analysis changes of preoperative and post-operative carotid angioplasty stent (CAS)in patients of carotid artery stenosis.Methods:47 carotid artery stenosis patients in our study , among this patients, 33males and 14 females ,mean age 60.56士7.23. In this patients 43 combine hypertensive disease and 7 combine diabetes, 23 combine hyperlipoidemia. Control group have 10 peoples (7males and 3 females), mean age 58.03±7.16, 7 combine hypertensive disease and 2combine diabetes, 5 combine hyperlipoidemia. 57 patients were divided into four groups : Control group(10 patients), light carotid artery stenosis group(21patients), midrange carotid artery stenosis group (14 patientis )and severe carotid artery stenosis group(12 patients).3 patients combine two vessels pathological change in severe carotid artery stenosis group. 12 severe carotid artery stenosis to confirmed by brain angiography and to accept carotid angioplasty stent (CAS). Through the method of breathholding, hyperventilation and rebreath CO₂ to change the density CO₂ in blood, continuous moniton both middle cerebral artery blood flow rate change by TCD detection (DWL MDX 0630, Germany) Whole test that patients take a mask have CO₂ transmitter. Calculate the value of vascularmotorreactivity VMR, cerebrovascularreserve capacity, CRC and breath-holding index, BHI to estimate cerebral vascular reactivity.Results: Compare with control group: There is no difference in carotid artery stenosis <70%,but have significant difference in carotid artery stenosis>70% in value of VMR, BHI, CRC. The side of carotid artery stenosis obviously lower than opposite side in VMR,BHI,CRC. There have obviously change of preoperative and post-operative carotid angioplasty stent (CAS)in patients of carotid artery stenosis inVMR,BHI,CRC. All groups have no difference in end–tidal CO₂.Therefore, the value of VMR,BHI, CRC can estimate cerebral vascular reactivity and TCD detect CVR is feasibility.Conclusion:1 TCD detect CVR is feasibility.2.The value of VMR,BHI, CRC can estimate cerebral vascular reactivity.3. There is no difference in light carotid artery stenosis group but severe carotid artery stenosis obviously decrease in CVR.4.CVR is better clinincal observation index for preoperative and post-operative carotid angioplasty stent (CAS)in patients.