经颅多普勒超声血流动力学参数对于重症颅脑损伤继发急性脑梗死的诊断价值  

Diagnostic value of transcranial Doppler hemodynamic parameters in acute cerebral infarction secondary to severe craniocerebral injury

作　　者：温亚东 杨雪妹 翁海蓉 吕小红[1] 唐宁[1] Wen Yadong;Yang Xuemei;Weng Hairong;Lyu Xiaohong;Tang Ning(Yijishan Hospital of Wannan Medical College,Wuhu 241001,Anhui,China)

机构地区：[1]皖南医学院弋矶山医院,安徽芜湖241001

出　　处：《右江民族医学院学报》2020年第6期742-745,共4页Journal of Youjiang Medical University for Nationalities

摘　　要：目的探讨经颅多普勒超声血流动力学参数对于重症颅脑损伤继发急性脑梗死的诊断价值。方法选取我院于2018年1月—2019年12月收治的341例诊断为重型颅脑损伤的患者作为研究对象,根据患者住院期间是否发生急性脑梗死分为脑梗死组和非脑梗死组。比较两组患者大脑中动脉(MCA)血流动力学参数差异。采用Logistic回归分析筛选具有预后诊断价值的指标,并采用ROC曲线评价回归方程的诊断效能。结果341例患者中,共计有44例患者在住院期间发生脑梗死。相较于非脑梗死组,合并有脑梗死患者MCA的收缩期血流速度(Vs)(72.85±9.97 vs 82.69±11.01)和舒张末期血流速度(Vd)(28.28±10.93 vs 40.48±11.13)显著降低,而搏动指数(PI)(0.87±0.20 vs 0.79±0.12)显著增高,差异具有统计学意义(P<0.05)。Logistic回归分析发现,MCA的Vs(OR=1.115,95%CI:1.070~1.162)、Vd(OR=1.121,95%CI:1.078~1.166)和PI(OR=0.030,95%CI:0.002~0.497)与重型颅脑损伤后继发脑梗死显著相关,差异具有统计学意义(P<0.05)。受试者工作特征(ROC)曲线分析提示MCA超声参数Vs、Vd和PI的曲线下面积(AUC)分别为0.742、0.787和0.731,而两者联合预测概率AUC为0.907,相较于单个指标显著提升,结果具有统计学意义(P<0.01)。结论经颅多普勒超声检查MCA血流动力学参数Vs、Vd和PI可显著提高对重型颅脑损伤后继发脑梗死的预测价值,具有较高的临床应用前景,值得进一步推广使用。Objective To explore the diagnostic value of transcranial Doppler ultrasound hemodynamic parameters in acute cerebral infarction secondary to severe craniocerebral injury.Methods A total of 341 patients diagnosed with severe craniocerebral injury admitted in our hospital from January 2018 to December 2019 were selected as the research subjects.According to whether acute cerebral infarction occurred during hospitalization,they were divided into cerebral infarction group and non-cerebral infarction group.The differences in the hemodynamic parameters of middle cerebral artery(MCA)between two groups were compared.Indicators with prognostic diagnostic value were screened by Logistic regression analysis,and ROC curve was used to evaluate the diagnostic efficacy of regression equation.Results Among 341 patients,a total of 44 patients had cerebral infarction during hospitalization.Compared with those of the non-cerebral infarction group,the systolic blood flow velocity(Vs)(72.85±9.97 vs 82.69±11.01)and end-diastolic velocity(Vd)(28.28±10.93 vs 40.48±11.13)of MCA in patients with cerebral infarction were significantly lower,while the pulsatility index(PI)(0.87±0.20 vs 0.79±0.12)significantly increased,the differences were statistically significant(P<0.05).Logistic regression analysis showed that Vs(OR=1.115,95%CI:1.070~1.162),Vd(OR=1.121,95%CI:1.078~1.166)and PI(OR=0.030,95%CI:0.002~0.497)of MCA were significantly correlated with secondary cerebral infarction after severe craniocerebral injury,with statistically significant differences(P<0.05).The ROC curve analysis indicated that the AUC of MCA ultrasonic parameters,Vs,Vd and PI,were 0.742,0.787 and 0.731,respectively.And the combined prediction probability AUC of the two was 0.907,which was significantly improved in comparison with single indicator,and the results were statistically significant(P<0.01).Conclusion MCA hemodynamic parameters Vs,Vd and PI from Transcranial Doppler ultrasound examination can significantly improve the predictive value of cerebral infar

关 键 词：经颅多普勒超声 颅脑损伤 脑梗死 诊断价值 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R455.1[医药卫生—临床医学]