中风与神经疾病杂志2025，Vol.42Issue(11)：974-978,5.DOI:10.19845/j.cnki.zfysjjbzz.2025.0178
2型糖尿病体位性脑血流动力学变化与其不良预后的相关性研究
Postural cerebral hemodynamic changes in patients with type 2 diabetes mellitus and their association with adverse outcomes
摘要
Abstract
Objective The supine-to-standing transcranial Doppler(TCD)technique is suitable for evaluating cardiovas-cular autonomic dysfunction,and this study aims to assess its performance in predicting adverse outcomes in diabetic patients with or without orthostatic hypotension(OH).Methods The patients with type 2 diabetes mellitus who were admitted to Department of Endocrinology and Department of Neurology in The Second Affiliated Hospital of Hainan Medical University from August 2020 to May 2023 were enrolled as subjects.Basic clinical data were collected,and supine-to-standing TCD was performed to monitor and record the changes in blood pressure,heart rate,and cerebral hemodynamics in both supine and standing positions.The patients were followed for 2‒4 years to record medication,orthostatic intolerance score,and adverse events.The two-independent-samples t test was used for comparison of normally distributed continuous variables between groups,and the Mann-Whitney U test was used for comparison of non-normally distributed continuous variables between groups;the chi-square test was used for comparison of cat-egorical variables between groups.The binary logistic regression analysis was used to investigate the association between the results of supine-to-standing TCD and adverse outcomes.Results A total of 118 patients(96 male patients and 22 female patients)were enrolled,among whom there were 28 patients with OH(23.7%)and 90 patients without OH(76.3%).During follow-up,19 pa-tients(16.1%)experienced adverse outcomes(including syncope,falls,and death).TCD showed that impaired"W"wave re-covery in cerebral blood flow in the standing position was an independent risk factor for adverse outcomes in diabetic patients(OR=3.536,95%CI 1.136‒11.006,P=0.029).Conclusion Vascular reflex failure and paradoxical cerebral vasoconstriction may be the mechanisms for impaired cerebral blood flow recovery in the standing position.TCD testing has an important role in detect-ing cerebrovascular abnormalities and cerebral hemodynamic changes,especially in diabetic patients with OH,and it has good per-formance in predicting adverse outcomes.关键词
2型糖尿病/卧立位TCD测试/直立性低血压/脑血流回调Key words
Type 2 diabetes mellitus/Supine-to-standing transcranial Doppler test/Orthostatic hypoten-sion/Cerebral blood flow recovery分类
医药卫生引用本文复制引用
李彦琳,唐玮婷,李双杏,李姝莹,张进伟,游咏..2型糖尿病体位性脑血流动力学变化与其不良预后的相关性研究[J].中风与神经疾病杂志,2025,42(11):974-978,5.基金项目
海南省科技厅重点研发项目(ZDYF2024SHFZ064) （ZDYF2024SHFZ064）
