贫血患者治疗前后脑血流动力学变化特点

目的 探讨不同程度的贫血患者脑血流动力学特点，分析经治疗后脑动脉血流速度的变化。方法 选取2018年6月至2020年1月在合肥市第二人民医院血液内科门诊和住院收治的贫血患者68例，根据贫血严重程度，分为轻度贫血组（n=32）与中重度贫血组（n=36），选择同期门诊健康体检者30例作为对照组，经颅多普勒超声检测，比较各组对象脑血流速度的差异。并对两组贫血患者治疗前后脑血流速度改变进行对比分析。结果 中重度贫血组较轻度贫血组和对照组各血管（LMCA、RMCA、BA、LVA和RVA）的平均血流速度增快（P<0.05），轻度贫血组和对照组各血管平均血流速度相比，差异无统计学意义（P>0.05）。中重度贫血患者经治疗后各血管的平均血流速度较治疗前均明显减慢（P<0.05），而轻度贫血组患者治疗后与治疗前各血管平均血流速度无显著差异（P>0.05）。中重度贫血组患者LMCA、BA、LVA和RVA治疗前后血流速度变化程度显著高于轻度贫血组（P<0.05），而RMCA与轻度贫血组相比无明显差异（P>0.05）。结论 中重度贫血可造成脑血流速可逆性增快，监测贫血患者的脑血流速度可能对治疗起到一定的指导意义。

Changes of cerebral hemodynamics in patients with anemia before and after treatment

Objective To investigate the characteristics of cerebral hemodynamics in patients with anemia of different degrees and analyze the changes of cerebral blood flow after treatment. Methods A total of 68 patients with anemia were selected from the outpatient and inpatient Department of Hematology of Hefei Second People''s Hospital from June 2018 to January 2020. According to the severity of anemia, the patients were divided into mild anemia group (32 cases) and moderate severe anemia group (36 cases). At the same time, 30 healthy outpatients were taken as the control group. The difference in cerebral blood flow velocity in each group was detected by transcranial Doppler ultrasound.The changes of cerebral blood flow velocity in two anemia groups were compared before and after treatment. Results The Vm of blood vessels (LMCA, RMCA, BA, LVA and RVA) in moderate and severe anemia group was faster than that in mild anemia group and control group (P<0.05), and there was no difference between mild anemia group and control group (P>0.05). After treatment, Vm of blood vessels in patients with moderate severe anemia was significantly lower than that before treatment (P<0.05), but there was no significant difference in Vm of each vessel between patients with mild anemia and those before treatment (P>0.05). The Vm of LMCA, BA, LVA and RVA in moderate severe anemia group was significantly higher than that in mild anemia group (P<0.05), while the Vm of RMCA had no significant difference compared with that in mild anemia group (P>0.05). Conclusions Moderate and severe anemia can cause reversible increase of cerebral blood flow velocity. Monitoring cerebral blood flow velocity in patients with anemia may play a guiding role in the treatment.