TCD监测颅内血流动力学变化与脑小血管病患者病情严重程度及神经功能恶化的相关性OACSTPCD

Objective To investigate the correlation of intracranial hemodynamic changes monitored by transcranial Doppler ultrasound(TCD)with the severity and neurological deterioration in patients with cerebral small vascular disease(CSVD),so as to provide reference for early treatment and improvement of prognosis of CSVD.Methods A total of 98 CSVD patients hospitalized in the Second Affiliated Hospital of Zhengzhou Universit from January 2022 to December 2023 were retrospectively included.MRI was used to evaluate the total MRI load of CSVD patients,and bilateral hemodynamic parameters of the middle cerebral artery(MCA)and anterior cerebral artery(ACA)were monitored by TCD.Mean velocity(Vm)and pulsitility index(PI)of MCA and ACA were compared between the mild to moderate load group and the severe load group.The correlation of the Vm and PI of MCA and ACA with the severity of MRI load in CSVD patients was analyzed.Patients with CSVD were divided into worsening group and the non-worsening group according to whether neurological function deteriorated within 1 week of admission.Vm and PI of MCA and ACA were compared between the worsening group and the non-worsening group,and the correlation of Vm and PI of MCA and ACA with neurological function deterioration in CSVD patients was analyzed.Results Vm of MCA and ACA in CSVD severe load group(41.35±5.47,35.44±3.37)was lower than that in mild to moderate load group(48.32±6.43,44.61±4.86),PI of MCA and ACA in CSVD severe load group(1.17±0.26,0.98±0.23)was higher than that in mild to moderate load group(0.92±0.21,0.78±0.19)(P<0.05).Vm of MCA and ACA was negatively correlated with the severity of MRI load,while PI was positively correlated with the severity of MRI load(P<0.05).The Vm of MCA and ACA in the worsening group(39.38±4.37,34.11±2.34)was lower than that in the non-worsening group(48.34±6.07,44.11±4.82),and the PI of MCA and ACA in the worsening group(1.25±0.22,1.06±0.16)was higher than that in the non-worsening group(0.91±0.19,0.76±0.19)(P<0.05).Vm in MCA and ACA was negatively correlated with neurological deterioration in CSVD patients,while PI was positively correlated with neurological deterioration in CSVD patients(P<0.05).Conclusion Abnormal intracranial hemodynamic parameters are correlated with the severity of CSVD patients and the occurrence of neurological dysfunction.Monitoring intracranial hemodynamic parameters of CSVD patients by TCD may early assess the severity and risk of neurological deterioration in CSVD patients.