超声评估血液透析患者脑血流自动调节功能  

Ultrasound Evaluation of Cerebral Blood Flow Autoregulation Function in Patients Underwent Hemodialysis

作　　者：杨佳欣 高卓 田颖 刘东 宋钰婷 姚克纯 刘禧 Yang Jiaxin;Gao Zhuo;Tian Ying;Liu Dong;Song Yuting;Yao Kechun;Liu Xi(Department of Ultrasonographic Diagnosis,Air Force Characteristic Medical Center of People's Liberation Army of China,Beijing 100142,China;Department of Nephrology,Air Force Characteristic Medical Center of People's Liberation Army of China,Beijing 100142,China)

机构地区：[1]中国人民解放军空军特色医学中心超声诊断科,北京市100142 [2]中国人民解放军空军特色医学中心肾内科,北京市100142

出　　处：《中国超声医学杂志》2024年第5期481-485,共5页Chinese Journal of Ultrasound in Medicine

基　　金：空军军医大学效能提升项目(No.2019ZTB05);空军特色医学中心科技助推揭榜挂帅项目(No.2022ZTJB01)。

摘　　要：目的应用经颅多普勒联合无创连续血压监测记录血液透析治疗患者的脑血流自动调节参数,评估血液透析患者的脑血流自动调节功能改变。方法选取47例血液透析治疗患者及年龄、性别匹配的20例健康志愿者进行前瞻性研究,获取大脑中动脉峰值流速、平均流速、搏动指数,并应用传递函数模型获取脑自动调节功能参数,包括极低频(<0.07 Hz)、低频(0.07~0.20Hz)、高频(>0.20 Hz)3个频段的增益、相位差和一致性函数,并进行比较分析。结果与对照组比较,病例组大脑中动脉峰值流速增高(P<0.05),平均流速及搏动指数差异无统计学意义(P>0.05)。病例组超低频段增益增高、相位差减低(P<0.001)。低频段及高频段内病例组增益、相位差差异均无统计学意义(P>0.05)。结论与健康志愿者相比,血液透析治疗患者的脑自动调节功能参数明显减低。经颅多普勒联合无创连续血压监测可以准确反映血液透析治疗患者的脑血流自动调节功能受损。Objective To evaluate the changes of the cerebral blood flow autoregulation function in patients underwent hemodialysis by using transcranial Doppler ultrasound combined with non-invasive continuous blood pressure monitor to record the cerebral blood flow autoregulation parameters.Methods A prospective study of cerebral blood flow autoregulation function was performed in 47 patients with hemodialysis treatment and 20 age and gender matched healthy volunteers.We obtained parameters of peak flow rate(Vmax),mean flow(Vmean),blood perfusion index.Cerebral blood flow autoregulation parameters were determined by transfer function model,including gain,phase,coherence of<0.07 Hz,0.07-0.20 Hz,>0.20 Hz.Results Compared with the control group,the cerebral blood flow parameters Vmax increased in patients underwent hemodialysis(P<0.05),and there was no significant difference in Vmean and pulsatility index(P>0.05).Gain increased and phase decreased in the ultra-low frequency band case group(P<0.001).There were no significant differences in gain and phase in the low and high frequency bands(P>0.05).Conclusions Compared with the healthy volunteers,functional parameters of cerebral autoregulation are significantly reduced in patients underwent hemodialysis.Transcranial Doppler ultrasound combined with non-invasive continuous blood pressure monitoring can accurately reflect the impaired cerebral blood flow autoregulation in patients underwent hemodialysis.

关 键 词：血液透析 脑血流自动调节 经颅多普勒超声 

分 类 号：R47[医药卫生—护理学]