脑小血管病患者脑动脉血流动力学状况与早期神经功能恶化的关系  

Relationship between cerebral arterial hemodynamic status and early neurological deterioration in patients with cerebral small vessel disease

作　　者：陈妍杏 陶袁媛 管义祥 Chen Yanxing;Tao Yuanyuan;Guan Yixiang(Department of Critical Care Medicine,Hai′an People′s Hospital,Nantong 226600,China)

机构地区：[1]海安市人民医院重症医学科,南通226600

出　　处：《中华保健医学杂志》2023年第6期613-616,共4页Chinese Journal of Health Care and Medicine

基　　金：江苏省卫生健康委科研项目(Z2019033)。

摘　　要：目的探讨脑小血管病(CSVD)患者脑动脉血流动力学状况与早期神经功能恶化(END)的关系。方法回顾性选取2020年1月~2022年1月海安市人民医院收治的129例CSVD患者,根据是否发生END分为END组(n=63)和非END组(n=66)。对比两组基础资料,采用经颅多普勒(TCD)检测患者大脑中动脉(MCA)及大脑前动脉(ACA)血流动力学信息,分析脑血流动力学指标与END的相关性。结果END组患者血清Hcy水平、美国国立卫生研究院卒中量表(NIHSS)评分显著高于非END组[(13.57±2.13)μmol L vs.(10.88±2.25)μmol L、(5.78±1.01)分vs.(3.02±0.81)分],MRI重度负担比例高于非END组[(1963)vs.(866)],差异有统计学意义(t=7.066、17.178;χ^(2)=6.337,P<0.05)。END组患者MCA-PI、ACA-PI显著高于非END组[(0.97±0.17)vs.(0.82±0.15)、(1.02±0.13)vs.(0.84±0.14)],MCA-PI不对称性比例高于非END组(34.92%vs.12.12%),差异有统计学意义(t=6.454、5.501;χ^(2)=9.388,P<0.05)。logistic回归分析显示,NIHSS评分、同型半胱氨酸(Hcy)、MRI总负担(重度)、MCA-PI、ACA-PI及MCA-PI不对称性是导致CSVD患者END发生的重要危险因素(P<0.05)。结论CSVD患者发生END的危险因素复杂,脑动脉血流动力学异常与CSVD患者END的发生密切相关。Objective To investigate the relationship between cerebral arterial hemodynamics and early neurological deterioration(END)in patients with cerebral small vessel disease(CSVD).Methods A total of 129 CSVD patients were selected from January 2020 to January 2022 and were divided into END group(63 cases)and non-END group(66 cases)according to the presence or absence of END.The basic data of the two groups were compared,and the hemodynamic information of the middle cerebral artery(MCA)and anterior cerebral artery(ACA)were detected by transcranial Doppler(TCD),and the correlation between cerebral hemodynamic indexes and END was analyzed.Results The serum Hcy level and NIHSS score in the END group were significantly higher than those in the non-END group[(13.57±2.13)μmol L vs.(10.88±2.25)μmol L,(5.78±1.01)points vs.(3.02±0.81)points],and the proportion of severe MRI burden in the END group was higher than that in the non-END group[(1963)vs.(866)](t=7.066,17.178,χ^(2)=6.337,P<0.05).The MCA-PI and ACA-PI in the END group were significantly higher than those in the non-END group[(0.97±0.17)vs.(0.82±0.15),(1.02±0.13)vs.(0.84±0.14)],and the proportion of MCA-PI asymmetry in the END group was higher than that in the non-END group(34.92%vs.12.12%)(t=6.454,5.501,χ^(2)=9.388,P<0.05).Logistic regression analysis showed that NIHSS score,Hcy,total MRI burden(severe),MCA-PI,ACA-PI and MCA-PI asymmetry were important risk factors for END in patients with CSVD(P<0.05).Conclusion The risk factors of END in patients with CSVD are complex.Cerebral artery hemodynamic abnormalities are closely related to the occurrence of END in patients with CSVD.

关 键 词：脑小血管病 早期神经功能恶化 血流动力学 危险因素 

分 类 号：R743[医药卫生—神经病学与精神病学]