TCD血流动力学指标评价急性脑梗死患者认知功能损伤程度的价值

目的 探讨经颅多普勒超声（TCD）检查评价急性脑梗死（ACI）后患者认知功能受损的价值。方法 选取2015年5月~2019年4月我院收治的ACI后合并认知功能障碍的患者110例设为认知障碍组，ACI后认知功能正常患者110例设为ACI组，比较两组的大脑中动脉（MCA）平均血流速度（Vm）、阻力指数（RI）、搏动指数（PI）、MCA的屏气指数（BHI）、不同程度认知障碍患者Vm、RI、PI、BHI测定值及认知障碍患者的MCA的Vm、RI、PI、BHI测定值与MoCA评分的关系。结果 认知障碍组的PI测定值高于ACI组，差异具有统计学意义（P＜0.05）；认知障碍组的BHI测定值、MoCA评分低于ACI组，差异具有统计学意义（P＜0.05）；两组Vm、RI测定值比较，差异无统计学意义（P＞0.05）；中度认知障碍患者的PI测定值高于轻度认知障碍患者，差异具有统计学意义（P＜0.05）；中度认知障碍患者BHI测定值、MoCA评分低于轻度认知障碍患者，差异具有统计学意义（P＜0.05）；认知障碍组PI测定值与MoCA评分呈负相关（r=-0.492，P=0.000）；认知障碍组的BHI测定值与MoCA评分呈正相关（r=0.507，P=0.000）；两组Vm、RI与MoCA评分无相关性（r=-0.084、-0.107，P=0.226、0.214）。结论 ACI患者认知功能障碍患者MCA的PI指数升高、BHI降低，TCD血流动力学指标用于评价ACI患者发生认知功能损害具有一定的临床价值。

Value of TCD Hemodynamic Index in Evaluating the Degree of Cognitive Impairment in Patients with Acute Cerebral Infarction

Objective To investigate the value of transcranial Doppler ultrasound (TCD) in evaluating cognitive impairment in patients with acute cerebral infarction (ACI). Methods A total of 110 patients with cognitive impairment after ACI admitted in our hospital from May 2015 to April 2019 were selected as the cognitive impairment group, and 110 patients with normal cognitive function after ACI were selected as the ACI group. The average blood flow of the middle cerebral artery (MCA) in the two groups was compared. Velocity (Vm), resistance index (RI), pulsatility index (PI), breath holding index (BHI) of MCA, measured values of Vm, RI, PI, BHI in patients with different degrees of cognitive impairment, and Vm of MCA in patients with cognitive impairment,relationship between measured values of RI, PI, BHI and MoCA score.Results The PI measurement value in the cognitive impairment group was higher than the ACI group,the difference was statistically significant (P<0.05); the BHI measurement value and MoCA score in the cognitive impairment group were lower than the ACI group,the difference was statistically significant (P＜0.05) ; Comparison of measured values of Vm and RI between the two groups was not statistically significant (P>0.05); PI measurement of patients with moderate cognitive impairment was higher than that of patients with mild cognitive impairment,the difference was statistically significant (P＜0.05);The BHI measurement value and MoCA score of patients with moderate cognitive impairment were lower than those of mild cognitive impairment,the differences were statistically significant (P<0.05); the PI measurement value of the cognitive impairment group was negatively correlated with the MoCA score (r=-0.492, P=0.000); BHI measurements in the cognitive impairment group were positively correlated with MoCA scores (r=0.507, P=0.000); there was no correlation between Vm, RI and MoCA scores in the two groups (r=-0.084, -0.107, P=0.226, 0.214).Conclusion The MCA PI index and BHI decrease in patients with cognitive impairment in ACI patients. The TCD hemodynamic index has a certain clinical value in evaluating cognitive impairment in ACI patients.