目的：研究风湿性心脏病伴发血栓脱落致脑栓塞(stroke caused by thrombosis of rheumatic heart disease，RHD)患者的血流动力学特征。方法：用经颅多普勒超声(transcranial Doppler，TCD)连续观查30例确诊的风湿性心脏病伴发血栓脱落致脑栓塞患者，另选同期在我院体检中心体检的正常患者60例进行对照。结果：RHD患者主要表现为椎基底动脉收缩期血流缓慢、脉动指数降低、Vp和Vm间的差距变小、波峰圆钝、多数患者出现频窗充填。除Vd值以外，两组病人左右椎动脉和基底动脉的Vp、Vm、PI值间均存在显著性差异(P<0.05)。结论：RHD患者的血流动力学表现具有相对的特异性，TCD可作为其临床初步筛查和辅助诊断手段之一。
Evaluation of hemodynamics in stroke patients caused by thrombosis of rheumatic heart disease
Objective: To study the hemodynamic character in stroke patients caused by thrombosis of rheumatic heart disease (RHD). Methods: 30 cases of RHD were examined with transcranial Doppler (TCD), and meanwhile, 60 normal patients were also examined with TCD as control. Results: The hemodynamic character in vertebral basilar artery in patients with RHD mainly showed slower systolic blood flow, more decreased pulsating index and smaller gap between the Vp and Vm, which displayed rounded peaks and the frequency window of filling. There were significantly differences in Vp, Vm, PI values of the vertebral artery and basilar artery between the two groups (P<0.05), while the Vd value had no such difference. Conclusion: The patients with RHD had relative specificity hemodynamic character, and TCD can be used as an initial screening and diagnosis means of RHD.