摘要
目的总结脑梗死后遗症期视网膜中央动脉(CRA)的血流特征,分析其与血管性认知障碍(VCI)的相关性。方法纳入脑梗死后遗症期患者95例为病例组,健康志愿者77例为对照组。应用平面波超敏感血流显像技术(Angio PLUS)检测两组CRA血流参数,包括收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)、阻力指数(RI)及搏动指数(PI),比较两组CRA各血流参数及临床资料的差异;采用二元Logistic回归分析脑梗死的独立危险因素。采用简易精神状态检查量表(MMSE)评估病例组患者认知功能并据此将发生VCI的患者分为轻度认知障碍(MCI)者和血管性痴呆(VaD)者。比较病例组中MCI者与VaD者、对照组中有无脑梗死因素者、病例组脑梗死患侧与健侧各CRA血流参数的差异;采用Spearman秩相关系数评价CRA血流参数与是否发生VCI、VCI程度的相关性。结果病例组与对照组糖尿病、高血压、体质量指数(BMI)异常占比比较,差异均有统计学意义(均P<0.05)。二元Logistic回归分析显示,高血压、糖尿病、BMI异常均为脑梗死的独立危险因素(均P<0.05)。Angio PLUS检查结果显示,病例组与对照组PSV、EDV、RI、PI比较,差异均有统计学意义(均P<0.05);病例组中VaD者EDV较MCI者减小,RI、PI均较MCI者增大,差异均有统计学意义(均P<0.05);对照组中有无脑梗死危险因素(高血压、糖尿病、BMI异常)者各CRA血流参数比较,差异均无统计学意义;病例组脑梗死患侧与健侧各CRA血流参数比较,差异均无统计学意义。相关性分析显示,PSV、EDV与是否发生VCI均呈负相关(r=-0.237、-0.477,均P<0.01),RI、PI与是否发生VCI均呈正相关(r=0.459、0.450,均P<0.01);EDV与VCI程度呈负相关(r=-0.240,P=0.020),RI、PI与VCI程度均呈正相关(r=0.213、0.209,均P<0.01)。结论脑梗死后遗症期患者的CRA血流有一定特征性表现,且其与VCI发生相关,有一定的临床价值。
Objective To summarize the blood flow characteristics of the central retinal artery(CRA)during postcerebral infarction period,and to analyze its correlation with vascular cognitive impairment(VCI).Methods Ninety-five patients during postcerebral infarction period were included as case group,and 77 healthy volunteers were included as control group.Angio plane wave ultrasensitive imaging(Angio PLUS)was used to explore the blood flow parameters of CRA,including peak systolic blood flow velocity(PSV),end-diastolic blood flow velocity(EDV),resistance index(RI)and pulsation index(PI),the differences of CRA and clinical date between the two groups were analyzed.The risk factors of cerebral infarction were analyzed by binary Logistic regression.The subjects’cognitive functions were evaluated by the Mini-Mental State Examination(MMSE),and the patients with VCI in the case group were further classified into mild cognitive impairment(MCI)group and vascular dementia(VaD)group.The differences of blood flow parameters of CRA in patients with or without cerebral infarction in control group,MCI patients and VaD patients in case group,patients with cerebral infarction and healthy patients were compared.Spearman rank correlation coefficient was used to evaluate the correlation between blood flow parameters of CRA and the occurrence and severity of VCI.Results There were significant differences in the proportion of diabetes,hypertension and abnormal body mass index(BMI)between the case group and control group(all P<0.05).Binary Logistic regression analysis showed that hypertension,diabetes and abnormal BMI were independent risk factors for cerebral infarction(all P<0.05).Angio PLUS showed that PSV,EDV,RI and PI were significantly different between the case group and control group(all P<0.05).In the case group,EDV of VaD patients was lower than that of MCI patients,while RI and PI were higher than those of MCI patients,with statistical significance(all P<0.05).There were no significant difference in blood flow parameters of CRA in
作者
陈亚萍
刘廷琼
李渝
但思宇
蒋国会
岳文胜
CHEN Yaping;LIU Tingqiong;LI Yu;DAN Siyu;JIANG Guohui;YUE Wensheng(Department of Ultrasound,the Affiliated Hospital of North Sichuan Medical College,Sichuan 637000,China)
出处
《临床超声医学杂志》
CSCD
2024年第4期328-333,共6页
Journal of Clinical Ultrasound in Medicine
基金
川北医学院揭榜挂帅项目(2022JB001)。
关键词
超声检查
脑梗死
视网膜中央动脉
血管性认知障碍
血流动力学
Ultrasonography
Cerebral infarction
Central retinal artery
Vascular cognitive impairment
Hemodynamics
