摘要
目的探讨经颅多普勒超声在脓毒症相关性脑病诊断中的临床应用价值。方法选取我院收治的脓毒症患者38例,每日对其进行早、晚2次谵妄评估,以重症加护病房谵妄评估量表为诊断脓毒症相关性脑病的标准,将患者分为脓毒症脑病组14例和非脓毒症脑病组24例,均行经颅多普勒超声检查,记录大脑中动脉收缩期峰值流速(Vs)、舒张末期流速(Vd)、平均流速(Vm)及搏动指数(PI);比较两组上述指标及急性生理与慢性健康状况评分Ⅱ(APACHEⅡ)、格拉斯哥昏迷量表(GCS)评分的差异。分析各超声指标与APACHEⅡ、GCS评分的相关性;绘制受试者工作特征(ROC)曲线评估各超声指标对脓毒症相关性脑病的诊断效能。结果脓毒症脑病组Vs、Vd、Vm、GCS评分均低于非脓毒症脑病组,PI、APACHEⅡ均高于非脓毒症脑病组,差异均有统计学意义(均P<0.05)。相关性分析显示,脓毒症相关性脑病患者Vs、Vd、Vm与APACHEⅡ均呈负相关,PI与APACHEⅡ呈正相关(均P<0.05);Vs、Vd、Vm与GCS评分均呈正相关,PI与GCS评分呈负相关(均P<0.05)。ROC曲线分析显示,Vs、Vm、PI诊断脓毒症相关性脑病的曲线下面积分别为0.756、0.780、0.830(均P<0.05)。结论经颅多普勒超声在脓毒症相关性脑病的诊断中具有一定临床应用价值。
Objective To explore the clinical application value of transcranial Doppler ultrasound in the diagnosis of sepsis associated encephalopathy.Methods A total of 38 patients with sepsis who were admitted to our hospital were selected,and delirium was assessed twice a day in the morning and evening.The results of the Confusion Assessment Method for the ICU were used as the criteria for diagnosing sepsis associated encephalopathy,the patients were divided into sepsis encephalopathy group(n=14)and non-sepsis encephalopathy group(n=24).Transcranial Doppler ultrasonography was performed to record the peak systolic velocity(Vs),end diastolic velocity(Vd),mean velocity(Vm),and pulsatility index(PI)of middle cerebral artery.The differences of the above parameters,acute physiology and chronic health evaluationⅡ(APACHEⅡ)and Glasgow coma scale(GCS)score were compared between the two groups.The correlation between each ultrasonic index and APACHEⅡ,GCS score was analyzed.Receiver operating characteristic(ROC)curve was drawn to evaluate the diagnostic efficacy of each ultrasonic index in sepsis associated encephalopathy.Results The Vs,Vd,Vm and GCS in sepsis encephalopathy group were lower than those in non-sepsis encephalopathy group,while PI and APACHEⅡwere higher than those in non-sepsis encephalopathy group,with statistical significance(all P<0.05).Correlation analysis showed that Vs,Vd and Vm were negatively correlated with APACHEⅡ,and PI was positively correlated with APACHEⅡ(all P<0.05).Vs,Vd and Vm were positively correlated with GCS score,and PI was negatively correlated with GCS score(all P<0.05).ROC curve analysis showed that the area under the curve of Vs,Vm and PI for diagnosing sepsis associated encephalopathy were 0.756,0.780 and 0.830,respectively(all P<0.05).Conclusion Transcranial Doppler ultrasound has a certain clinical value in the diagnosis of sepsis associated encephalopathy.
作者
彭彬
刘碧明
秦松
董敏
贺凌云
王云燕
聂亚玲
吴成立
黄天向
张静
汪顺利
PENG Bin;LIU Biming;QIN Song;DONG Min;HE Lingyun;WANG Yunyan;NIE Yaling;WU Chengli;HUANG Tianxiang;ZHANG Jing;WANG Shunli(Department of Intensive Care,Yunyang County People’s Hospital,Chongqing 404599,China)
出处
《临床超声医学杂志》
CSCD
2023年第12期1006-1009,共4页
Journal of Clinical Ultrasound in Medicine
基金
重庆市科卫联合医学科研项目(2021MSXM324)。
关键词
超声检查
多普勒
经颅
脓毒症
相关性脑病
Ultrasonography,Doppler,transcranial
Sepsis
Associated encephalopathy
