経頭蓋超音波ドプラ法による脳循環の評価(第2報) ： 頭蓋内主幹動脈血流動態と動脈硬化関連因子

Abstract

In this study, the relationship between the hemodynamics of the basal cerebral arteries by transcranial Doppler arteriography (TCDA) and atherogenic factors was investigated. The subjects were 446 patients having no abnormalities on brain CT. They were divided into 3 groups : 229 without hypertension (HT) or diabetes mellitus (DM) as controls (Group Ⅰ), 157 with HT (Group Ⅱ) and 60 with both HT and DM (Group Ⅲ). The mean blood velocity (BV) and Fourier pulsatility index (Fourier PI) in the basilar artery (BA) and the middle cerebral artery (MCA) were measured. In Group Ⅰ, Fourier PI of the BA and the MCA increased while BV of the BA and the MCA decreased slightly. BA-Fourier PI in Group Ⅱ and Group Ⅲ increased notably compared with Group Ⅰ in the age groups of 50-59, 60-69 and 70-79. MCA-Fourier PI in Group Ⅱ and Group Ⅲ increased compared with Group Ⅰ in the age groups of 60-69 and 70-79. On the other hand, no significant differences were seen in the BV among the 3 groups. Multivariate analysis for intracranial hemodynamics by TCDA and atherogenic factors showed that age, HT, DM and atherogenic index contributed to the increase of Fourier PI. These results indicate that Fourier PI increases in the elderly. The complications of both HT and DM might cause Fourier PI to increase in the elderly.