血液流变学指标及脑血流灌注量与慢性脑供血不足患者脑供血动脉狭窄的关系探究  

Hemorheology indexs and cerebral blood flow perfusion and the relationship between the brain artery stenosis patients with chronic brain

作　　者：陈思文 任倩萌 张龙飞 CHEN Si-wen;REN Qian-meng;ZHANG Long-fei(Department of Neurology,Tongchuan People's Hospital,Tongchuan Shaanxi 727031,China)

机构地区：[1]铜川市人民医院神经内科,陕西铜川727031

出　　处：《临床和实验医学杂志》2024年第13期1360-1363,共4页Journal of Clinical and Experimental Medicine

基　　金：陕西省中医药管理局项目(编号:2021-ZZ-LC008)。

摘　　要：目的探究血液流变学指标及脑血流灌注量与慢性脑供血不足患者脑供血动脉狭窄的关系。方法回顾性选取2021年1月至2023年10月在铜川市人民医院就诊的96例慢性脑供血不足患者作为观察组。根据脑供血动脉狭窄程度,将其分为轻中度狭窄组(n=36)和重度狭窄组(n=60)。另选同期96名健康体检者纳入对照组。检测与比较观察组与对照组、轻中度狭窄组和重度狭窄组的血液流变学指标(全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原)水平、脑血流灌注量;使用多因素Logistic回归分析血液流变学指标及脑血流灌注量与慢性脑供血不足患者脑供血动脉重度狭窄的关系;使用受试者操作特征(ROC)曲线分析血液流变学指标及脑血流灌注量对慢性脑供血不足患者脑供血动脉重度狭窄的预测效能。结果观察组的全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原水平分别为(9.12±1.57)mPa/s、(42.12±4.56)mPa/s、(2.38±0.45)mPa/s、(3.96±0.58)g/L,均高于对照组[(7.20±0.86)mPa/s、(30.25±2.07)mPa/s、(1.61±0.23)mPa/s、(2.41±0.29)g/L],脑血流灌注量为(542.12±45.63)mL/min,少于对照组(661.25±67.84)mL/min,差异均有统计学意义(P<0.05)。重度狭窄组的全血高切黏度、全血低切黏度、血浆黏度、纤维蛋白原水平分别为(9.94±1.80)mPa/s、(49.37±5.26)mPa/s、(2.97±0.61)mPa/s、(4.65±0.73)g/L,均高于轻中度狭窄组[(8.36±1.35)mPa/s、(35.68±3.14)mPa/s、(2.05±0.34)mPa/s、(3.24±0.37)g/L],脑血流灌注量为(520.16±40.78)mL/min,少于轻中度狭窄组[(589.42±52.17)mL/min],差异均有统计学意义(P<0.05)。经多因素Logistic回归分析,血浆黏度、纤维蛋白原和脑血流灌注量均是慢性脑供血不足患者脑供血动脉重度狭窄的独立预测因素(P<0.05)。经ROC曲线分析,血浆黏度、纤维蛋白原、脑血流灌注量预测慢性脑供血不足患者脑供血动脉重度狭窄的曲线下面积(AUC)分�Objective To explore the relationship between hemorheology indexs,cerebral blood perfusion volume and cerebral artery stenosis in patients with chronic cerebral insufficiency.Methods 96 patients with chronic cerebral ischemia who visited Tongchuan People's Hospital from January 2021 to October 2023 were retrospectively selected as the observation group.According to the degree of brain artery stenosis,they were divided into the mild-to-moderate stenosis(n=36)and the severe stenosis group(n=60).At the same time,96 healthy subjects were included in the control group.The levels of hemorheological indexs(whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity,fibrinogen)and cerebral blood flow perfusion were detected and compared between the observation group and the control group,the mild to moderate stenosis group and the severe stenosis group.The relationship between hemorheology indexes and cerebral blood flow perfusion and severe stenosis of cerebral artery in patients with chronic cerebral insufficiency was analyzed by multivariate Logistic regression analysis.The predictive efficacy of hemorheological indexs and cerebral blood flow perfusion on severe cerebral artery stenosis in patients with chronic cerebral ischemia was analyzed using receiver operating characteristic(ROC)curves.Results The whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity,and fibrinogen water in the observation group were(9.12±1.57)mPa/s,(42.12±4.56)mPa/s,(2.38±0.45)mPa/s,and(3.96±0.58)g/L,respectively,which were higher than those in the control group[(7.20±0.86)mPa/s,(30.25±2.07)mPa/s,(1.61±0.23)mPa/s,and(2.41±0.29)g/L],and the cerebral blood flow perfusion was(542.12±45.63)mL/min,which was lower than that in the control group[(661.25±67.84)mL/min],the differences were statistically significant(P<0.05).The whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity,and fibrinogen levels in the severe stenosis group were(9.94±1.80)mPa/s,(49.37±5.26)mP

关 键 词：慢性脑供血不足 血液流变学指标 脑血流灌注量 脑供血动脉狭窄 

分 类 号：R743.3[医药卫生—神经病学与精神病学]