Abstract: Objective　To study the changes of cardiac function and intracranial arterial hemodynamics in patients with acute cerebral infarction (ACI) by ultrasonography. Methods　Seventy-nine patients with ACI treated at Department of Neurology, Lianyungang Second People's Hospital from January to December 2019 were selected as an ACI group, including 50 males and 29 females, and they were 42-87 (66.27±9.89) years old. Thirty-three healthy examinees during the same period were selected as a control group, including 19 males and 14 females, and they were (64.15±10.11) years old. Both groups underwent cardiac color Doppler ultrasonography to obtain cardiac structure and function indicators, arterial ultrasonography to obtain arterial inner diameter, blood flow velocity, resistance index, and arterial intima-media thickness, and transcranial Doppler ultrasonography to obtain intracranial artery blood flow rate. The measurement data were compared between these two groups by the independent-sample t test, and the rates by χ² test. Results　(1) The left atrial diameter, right atrial diameter, left ventricular end-diastolic diameter, and pulmonary artery pressure were (39.40±3.13) mm, (50.26±3.48) mm, (23.93±1.89) mm, and (38.11±3.37) mmHg (1 mmHg=0.133 kPa) in the ACI group, and were (38.00±3.32) mm, (48.82±2.51) mm, (22.89±1.23) mm, and (36.08±2.35) mmHg in the control group, with statistical differences (t=2.007, 2.276, 2.677, and 2.907; P=0.048, 0.026, 0.009, and 0.005). (2) The left and right common carotid artery end-diastolic blood flow velocities (Vd), left internal carotid artery Vd, and right internal carotid artery peak systolic flow velocity (Vs) in the ACI group were lower than those in the control group, with statistical differences (all P<0.05). The resistance indexes of the left and right common carotid arteries in the ACI group were higher than those in the control group, with statistical differences (both P<0.05). End diastolic velocity difference of bilateral vertebral arteries in ACI group(ΔVd) was significantly higher than that in the control group (P<0.05). (3) The Vd of the right anterior cerebral artery in the ACI group was higher than that in the control group, with a statistical difference (P<0.05). The ΔVd's of anterior cerebral arteries, middle cerebral arteries, and vertebral arteries on both sides in the ACI group were higher than those in the control group, with statistical differences (all P<0.05). Conclusion　Patients with ACI can improve their brain blood supply adjusting heart structure and intra-and extra-cranial arterial blood flow velocity.

Key words: Acute cerebral infarction, Echocardiography, Carotid artery ultrasound, Transcranial Doppler ultrasound, Hemodynamics

摘要： 目的　应用超声检测方法研究急性脑梗死患者心脏功能和颅内外动脉血流动力学变化。方法　选择2019年1月至12月连云港市第二人民医院神经内科住院的急性脑梗死（acute cerebral infarction，ACI）患者79例（ACI组），男50例，女29例，年龄42～87（66.27±9.89）岁；对照组为同期健康体检者33例，男19例，女14例，年龄41～86（64.15±10.11）岁。两组行心脏彩超检查获取心脏结构和功能指标，动脉超声检查获取动脉内径、血流速度、阻力指数和动脉内膜中层厚度；经颅多普勒超声检查获取颅内动脉血流速度。计量资料采用独立样本t检验，率的比较采用χ²检验。结果　（1）ACI组左房内径为（39.40±3.13）mm、左室舒张末期内径为（50.26±3.48）mm、右室内径为（23.93±1.89）mm、肺动脉压为（38.11±3.37）mmHg（1 mmHg=0.133 kPa），均较对照组增加［分别为（38.00±3.32）mm、（48.82±2.51）mm、（22.89±1.23）mm、（36.08±2.35）mmHg］，差异均有统计学意义（t=2.007、2.276、2.677、2.907，P=0.048、0.026、0.009、0.005）。（2）ACI组左、右颈总动脉舒张末期血流速度（Vd），左颈内动脉Vd及右颈内动脉收缩期峰值血流速度（Vs）均低于对照组，差异均有统计学意义（均P<0.05）；ACI组左、右颈总动脉阻力指数高于对照组，差异均有统计学意义（均P<0.05）。ACI组两侧椎动脉舒张末期流速差（ΔVd）高于对照组，差异有统计学意义（P<0.05）。（3）ACI组右侧大脑前动脉Vd高于对照组，差异有统计学意义（P<0.05）；ACI组两侧大脑前动脉ΔVd，两侧大脑中动脉ΔVd，两侧椎动脉ΔVd高于对照组，差异均有统计学意义（均P<0.05）。结论　ACI患者通过调节心脏结构与颅内外动脉血流速度以改善脑的供血。

关键词: 急性脑梗死, 心脏彩超, 颈动脉超声, 经颅多普勒超声, 血流动力学