经颅彩色多普勒超声对尿毒症合并抑郁症状患者脑血流动力学的研究  

Analysis of cerebral hemodynamics in uremic patients complicated with depressive symptoms using transcranial color-coded Doppler

作　　者：李宇航 张猛 杨淇惠 张纳[1] LI Yuhang;ZHANG Meng;YANG Qihui;ZHANG Na(Department of Electrodiagnostics,Central Hospital Affiliated to Shenyang Medical College,Shenyang 110024,China)

机构地区：[1]沈阳医学院附属中心医院电诊科,辽宁沈阳110024

出　　处：《沈阳医学院学报》2025年第2期174-179,224,共7页Journal of Shenyang Medical College

摘　　要：目的:分析尿毒症合并抑郁症状患者经颅彩色多普勒超声(transcranial color-coded doppler,TCCD)脑血流动力学特点,探讨脑血流动力学指标与尿毒症合并抑郁症状的相关性。方法:选取2022年12月至2023年12月在本院进行血液透析的尿毒症患者77例为研究对象,其中合并抑郁症状患者37例为研究组,同时未合并抑郁症状患者40例为对照组。比较2组双侧大脑中动脉收缩峰值流速(peak systolic velocity,PSV)、舒张末期流速(end diastolic velocity,EDV)、平均流速(mean velocity,MV)、搏动指数(pulsatility index,PI),采用二元Logistic回归分析方法分析增加尿毒症患者合并抑郁症状的危险因素,并选取有代表性参数绘制ROC曲线。结果:2组双侧大脑中动脉PSV比较差异无统计学意义(P>0.05),研究组双侧大脑中动脉EDV、MV低于而PI高于对照组(P<0.05)。年龄与尿毒症患者合并抑郁症状呈正相关,双侧大脑中动脉EDV、MV、左侧大脑中动脉PSV与抑郁症状呈负相关(P<0.05)。碳酸氢根离子(HCO_(3)^(-))水平升高增加尿毒症患者合并抑郁症状的风险(OR=1.245,95%CI:1.024~1.513)。当左侧大脑中动脉EDV=41.25 cm/s时,预测尿毒症患者合并抑郁症状的发生率为74.6%,特异性为62%,灵敏度为85%。结论:尿毒症合并抑郁症状患者大脑中动脉EDV、MV低于尿毒症未合并抑郁症状患者,年龄、双侧大脑中动脉EDV和MV及左侧大脑中动脉PSV与抑郁症状相关。当左侧大脑中动脉EDV<41.25 cm/s时,提示尿毒症患者存在合并抑郁症状的风险,TCCD可以为临床早期发现尿毒症患者合并抑郁症状提供参考。Objective:To analyze the cerebral hemodynamic characteristics of uremic patients complicated with depressive symptoms by transcranial color-coded Doppler(TCCD),and explore the correlation between cerebral hemodynamic indicators and uremia complicated with depressive symptoms.Methods:A total of 70 uremic patients received hemodialysis in our hospital from Dec 2022 to Dec 2023 were enrolled,in which 37 patients complicated with depressive symptoms were selected as the research group,and 40 patients without depressive symptoms were selected as the control group.Peak systolic velocity(PSV),end diastolic velocity(EDV),mean velocity(MV),and pulsatility index(PI)of bilateral middle cerebral artery(MCA)were compared.Binary logistic regression was used to analyze risk factors for uremia complicated with depressive symptoms,and receiver operating characteristic(ROC)curves were generated for key parameters.Results:There was no significant difference in PSV between the two groups(P>0.05),while EDV and MV of bilateral MCA in the research group were lower but PI was higher than those in the control group(P<0.05).Age was positively correlated with the depressive symptoms in uremic patients,while EDV,MV of bilateral MCA and left PSV were negatively correlated with depressive symptoms of uremic patients(P<0.05).The elevated level of-HCO_(3)^(-) in blood increased the risk of uremia complicated with depressive symptoms(OR=1.245,95%CI:1.024-1.513).When the left EDV was 41.25 cm/s,the predicted occurrence rate of depressive symptoms in uremic patients was 74.6%,with a specificity of 62%and a sensitivity of 85%.Conclusions:EDV and MV of bilateral MCA in patients with uremia complicated with depressive symptoms were lower than those in patients with uremia without depressive symptoms.Age,EDV and MV of bilateral MCA and PSV of left MCA were associated with depressive symptoms.Left EDV<41.25 cm/s may serve as a hemodynamic marker for early clinical detection of depressive symptoms in uremia.TCCD can provide a reference for early clinica

关 键 词：经颅彩色多普勒超声 尿毒症 抑郁症状 脑血流 

分 类 号：R743[医药卫生—神经病学与精神病学]