Correlation of abnormal intracranial vessel velocity, measured by transcranial Doppler ultrasonography, with abnormal conjunctival vessel velocity, measured by computer-assisted intravital microscopy, in sickle cell disease
Correlation of abnormal intracranial vessel velocity, measured by transcranial Doppler ultrasonography, with abnormal conjunctival vessel velocity, measured by computer-assisted intravital microscopy, in sickle cell disease
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DOI：
10.1182/blood.v97.11.3401
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发表时间：
2001-06-01
期刊：
影响因子：
20.3
通讯作者：
Vichinsky, EP
中科院分区：
文献类型：
--
作者：
Cheung, ATW;Harmatz, P;Vichinsky, EP
中风预防试验已经证实，利用经颅多普勒超声检查（TCD），检查颅内大血管中的血流，可以识别患有镰状细胞病（SCD）的儿童，这些儿童具有发生过早中风的高风险。目前尚不清楚SCD的血管病变累及小血管的程度，以及这些异常（如果存在）是否与大血管病变相关。同时对18例SCD患儿进行TCD检测大脑中动脉（MCA）血流速度和计算机辅助活体显微镜（CAIM）检测球结膜血管血流速度，高MCA速度4例经颅多普勒超声（TCD）检查为大于或等于200 cm/sec，同时伴有结膜速度异常（< 0.2 mm/sec或间歇性滴流），3例患者有条件（大于或等于170 cm/sec且< 200 cm/sec）MCA速度：2例结膜滴速异常，1例正常（1.9 mm/sec），1例MCA速度不可测量的患者结膜速度异常（滴流）。在其余10例MCA流速正常的患者中，2例显示异常（0.05 mm/sec和0.1 mm/sec），8例显示正常结膜流速（1.1-2.4 mm/sec）。MCA流速与球结膜流速显著相关（P 0.008，Fisher精确检验）。MCA（大血管）和结膜（小血管）流速之间存在相关性。CAIM是一种非侵入性的定量技术，可能有助于识别处于卒中高风险的SCD患者。小血管病变可能是一个重要的病理指标，应进一步探讨在一个大规模的研究。（血。2001;97：3401-3404）（C）2001由美国血液学学会。
The Stroke Prevention Trial has confirmed that utilization of transcranial Doppler ultrasonography (TCD), which examines blood flow in large intracranial vessels, can identify children with sickle cell disease (SCD) who are at high risk of developing a premature stroke. It is not known to what extent the vasculopathy in SCD involves small vessels and whether the abnormalities, if present, correlate with large-vessel vasculopathy. Eighteen children with SCD were examined with TCD to determine middle cerebral artery (MCA) velocity and computer-assisted intravital microscopy (CAIM) to determine bulbar conjunctival vessel velocity during the same visit for vasculopathy correlation, High MCA velocity (greater than or equal to 200 cm/sec) was found by TCD in 4 patients who also showed abnormal conjunctival velocity (< 0.2 mm/sec or intermittent trickle flow) by CAIM, Three patients had conditional (greater than or equal to 170 cm/sec and < 200 cm/sec) MCA velocity: 2 showed abnormal (trickle) and 1 showed normal conjunctival velocity (1.9 mm/sec), One patient with unmeasurable MCA velocity had abnormal (trickle) conjunctival velocity. Of the remaining 10 patients who had normal MCA velocity, 2 showed abnormal (0.05 mm/sec and 0.1 mm/sec) and 8 showed normal conjunctival velocities (1.1-2.4 mm/sec), The MCA velocities correlated significantly with bulbar conjunctival flow velocities (P .008, Fisher exact test). A correlation exists between MCA(large-vessel) and conjunctival (small-vessel) flow velocities. CAIM is a noninvasive quantitative technique that might contribute to the identification of SCD patients at high risk of stroke. Small-vessel vasculopathy might be an important pathological indicator and should be further explored in a large-scale study. (Blood. 2001;97:3401-3404) (C) 2001 by The American Society of Hematology.