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经颅多普勒超声对脑小血管病的作用 被引量:1

Transcranial Doppler ultrasound for screening cerebral small vessel disease:A Clinic Study
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摘要 目的 探讨老年人群经颅多普勒超声搏动指数(PI)与脑小血管疾病各型之间的关系.方法 对210例老年患者进行经颅多普勒超声(TCD)和磁共振成像(MRI)检查,评价大脑中动脉(MCA) PI与脑白质病变(WML)、小卒中和微出血之间的关系.结果 多因素Logistic回归发现,MCA PI与WML有关(优势比,MCA PI每增加0.1增加1.13,95%置信区间为1.06~1.80;P=0.02).就识别严重WML来说,在最佳MCA PI位点,曲线下面积、阳性预测值和阴性预测值分别为0.70(95%可信区间为0.60~0.80)、35.4%和86.6%.MCA PI与各种小卒中或微出血之间无明确相关性.结论 MCA PI与脑白质病变严重性相关,具有很高的阴性预测值,MCA PI正常时患严重WML的可能性低.在老年患者,TCD可用来指导进行选择性MRI扫描以发现WML. Objective We explored the association between pulsatility index(PI)as derive from transcranial Doppler ultrasound with various measures of small vessel disease in old patient. Methods We performed transcranial Doppler(TCD) and magnetic resonance imaging(MRI) in 210 consecutive outpatient elderly subjects who were participants of the Aging Study. We investigated the association between middle cerebral artery(MCA)PI with measures of white matter lesions(WML), lacunes, and microbleeds. Results Multiple Logistic regression found that MCA PI was associated with severe WML(odds ratio 1.13 per increase in PI; 95 % confidence interval 1.06- 1.80;P=0.02). At optimal MCA PI cut-off, the area under curve, positive predictive value,and negative predictive value were 0.70(95% confidence interval 0.60-0.80), 35.4%, and 86.6%, respectively, for detection of severe WML. No association was found between MCA PI and measures of lacunes or microb leeds. Conclusion MCA PI correlates with WML severity. With a high negative predictive value, the chance of having severe WML with a normal MCA PI is low. TCD may guide selective MRI scanning for the detection of WML in the community.
出处 《中国实用神经疾病杂志》 2016年第24期35-37,共3页 Chinese Journal of Practical Nervous Diseases
基金 国家自然科学基金面上项目(编号:81471203) 郑州市科技攻关项目(编号:20140462)
关键词 经颅多普勒超声 脑小血管病 Transcranial Doppler ultrasound cerebral small Vessel disease
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