经颅多普勒超声评估大脑中动脉血流动力学参数与脑卒中后神经功能恢复的相关性

摘要

Objective:To analyze the correlation between middle cerebral arterial hemodynamic parameters assessed by transcranial Doppler sonography and neural functional recovery after stroke.Methods:A total of 86 cases of hospitalized pa-tients with stroke were selected as observation group,107 cases of healthy subjects who received physical examination in our hospital during the same period were selected as control group,and both groups received the examination of middle cerebral ar-tery blood flow by transcranial Doppler sonography (TCD).According to the results of TCD,observation group were further divided into total occlusion group 21 cases,partial occlusion group 53 cases and non-occlusion group 12 cases.Middle cerebral arterial hemodynamic parameters,serum levels of neural function-related factors and serum levels of disease severity-related factors were compared among groups,and the correlation between the parameters of TCD and neural functional recovery after stroke was further analyzed.Results:Average Vs,Vm and Vd values of observation group were lower than those of control group,and as the degree of arterial occlusion increased,Vs,Vm and Vd values decreased (P <0.05);average NSE,S-100B, MBP,GFAP,Hcy,MMP-9,UA and Lp (a)values of observation group were higher than those of control group,BNDF was lower than that of control group,and as the degree of arterial occlusion increased in patients with stroke,the change tendency of the above factors increased (P <0.05);middle cerebral artery Vs,Vm and Vd values were negatively correlated with NSE, S-100B,MBP,GFAP,Hcy,MMP-9,UA and Lp (a)values,and positively correlated with BNDF value (P <0.05).Conclu-sions:Assessment of middle cerebral arterial hemodynamic parameters by transcranial Doppler sonography can accurately eval-uate long-term neural functional recovery of patients with stroke,and it has positive clinical significance.%目的：：分析经颅多普勒超声评估大脑中动脉血流动力学参数与脑卒中后神经功能恢复的相关性.方法：将住院治疗的86例脑卒中患者作为观察组,同期在本院进行健康体检的正常人107例作为对照组,均经颅多普勒超声(TCD)检查大脑中动脉血流情况.根据 TCD 结果观察组进一步被分为完全闭塞组21例,部分闭塞组53例,未闭塞组12例,对比各组大脑中动脉血流动力学参数、血清神经功能相关因子水平、血清病情严重程度相关因子水平,并进一步分析 TCD 参数与脑卒中后神经功能恢复的相关性.结果：观察组平均收缩期血流速度(Vs)、平均血流速度(Vm)、舒张期血流速度(Vd)值低于对照组,且随着动脉闭塞程度上升,Vs、Vm、Vd 值下降(P ＜0．05)；观察组平均神经元特异性烯醇化酶(NSE)、S100B 蛋白(S-100B)、髓鞘碱性蛋白(MBP)、神经胶质纤维酸性蛋白(GFAP)、同型半胱氨酸(Hcy)、基质金属蛋白酶-9(MMP-9)、血清尿酸(UA)、载脂蛋白(a)(Lpa)值高于对照组,脑源性神经营养因子(BDNF)低于对照组,且随着脑卒中患者动脉闭塞程度上升,以上因子变化趋势增加(P ＜0．05)；大脑中动脉 Vs、Vm、Vd 值与 NSE、S-100B、MBP、GFAP、Hcy、MMP-9、UA、Lp(a)值呈负相关关系,与BNDF 值呈正相关关系(P ＜0．05).结论：经颅多普勒超声评估大脑中动脉血流动力学参数可以准确评价脑卒中患者的远期神经功能恢复情况,具有积极的临床意义.