Chinese Journal of Stereotactic and Functional Neurosurgery ›› 2024, Vol. 37 ›› Issue (1): 1-5.DOI: 10.19854/j.cnki.1008-2425.2024.01.0001

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Correlation between autonomic nervous dysfunction and cerebral blood flow change in decubitus position in Parkinson's disease

Lu Xia1, Zhang Dan2, Jiang ZhaoXing3, Li Peihan1, Wang Hui1   

  1. 1. Second Affiliated Hospital of Xinjiang Medical University,Urumqi,830028,Xinjiang;
    2. First Jiqu Hospital of the Autonomous Region,Urumqi,830011,Xinjiang;
    3. People's Hospital of Wusu City,Xinjiang,833099
  • Received:2023-12-10 Online:2024-02-25 Published:2024-04-03
  • Contact: Wang Hui 810598807@qq.com

帕金森病自主神经功能障碍与卧立位脑血流变化的相关性研究

逯霞, 张丹, 江兆兴, 李沛珊, 王惠   

  1. 830028 乌鲁木齐 新疆医科大学第二附属医院神经电生理(逯霞,李沛珊,王惠),新疆维吾尔自治区第一济困医院肾病科(张丹),新疆维吾尔乌苏市人民医院神经内科(江兆兴)
  • 通讯作者: 王惠 810598807@qq.com
  • 基金资助:
    自治区重点实验室新疆神经系统疾病研究重点实验室开放课题(编号:XJDX1711-2235)

Abstract: Objective To analyze the correlation between autonomic dysfunction and cerebral blood flow in decubitus position in Parkinson's disease. Methods In December 2020 to July 2023 in our hospital 148 cases of Parkinson's patients into the study,according to whether the secondary autonomic nerve dysfunction,divided into autonomic nerve dysfunction group and simple set of Parkinson's disease.Using transcranial doppler ultrasonic testing all of the patients supine position and from supine position to set up a 3 min of middle cerebral artery systolic blood flow velocity (Vs),diastolic blood flow velocity (Vd),mean blood flow velocity (Vm),pulse index (PI) and resistance index (RI),record lie stand the change of cerebral blood flow parameter values,includes △Vs,△Vd,△Vm,△PI,and △RI. Results The autonomic nerve dysfunction group older than pure Parkinson's disease,duration longer than the simple set of Parkinson's disease,hypertension incidence,were significantly difference(P<0.05).As autonomic nerve dysfunction group delta as Vs,delta as Vd,delta as Vm,delta PI were greater than the simple set of Parkinson's disease,have significant difference(P<0.05).Multiple Logistic regression analysis showed that age,course of disease,△Vs and △PI were independent influencing factors of autonomic nervous dysfunction in PD patients(P<0.05).The Pearson correlation analysis,secondary as Parkinson's disease delta of autonomic nerve dysfunction as Vs,delta PI with age,duration,SCOPA-AUT scores were positively correlated(P<0.05).By ROC curve analysis,sensitivity of △Vs combined with △PI to diagnose autonomic nervous dysfunction in PD patients is 92.13%,specificity is 51.67% and AUC is 0.931. Conclusion The occurrence of autonomic dysfunction in PD patients is related to the changes of the middle cerebral artery Vs and PI in supine position,where △Vs combined with △PI can improve the diagnostic efficiency of autonomic dysfunction.

Key words: Parkinson&apos, s disease, Lying position, Middle cerebral artery, Cerebral blood flow changes, Autonomic dysfunction

摘要: 目的 分析帕金森病自主神经功能障碍与卧立位脑血流变化的相关性。方法 将2020年12月至2023年7月在我院住院治疗的148例帕金森病患者纳入研究,根据是否继发自主神经功能障碍,分为自主神经功能障碍组和单纯帕金森病组。使用经颅多普勒超声检测所有患者卧位及从卧位到立位第3 min时大脑中动脉的收缩期血流速度(Vs)、舒张期血流速度(Vd)、平均血流速度(Vm)、搏动指数(PI)和阻力指数(RI),记录卧立位脑血流参数的变化值,包括△Vs、△Vd、△Vm、△PI、△RI。结果 自主神经功能障碍组年龄大于单纯帕金森病组,病程长于单纯帕金森病组,高血压发病率高于单纯帕金森病组,差异均显著(P<0.05);自主神经功能障碍组△Vs、△Vd、△Vm、△PI均大于单纯帕金森病组,差异均显著(P<0.05);自主神经功能障碍组与单纯帕金森病组△RI比较,差异不显著(P>0.05);经多因素Logistic回归分析,年龄、病程、△Vs、△PI均是帕金森病患者发生自主神经功能障碍的独立影响因素(P<0.05);经Pearson相关性分析,继发自主神经功能障碍的帕金森病患者△Vs、△PI与年龄、病程、SCOPA-AUT评分均呈正相关(P<0.05);经ROC曲线分析,△Vs联合△PI诊断帕金森病患者发生自主神经功能障碍的敏感度为92.13%、特异度为51.67%、AUC为0.931。结论 帕金森病患者自主神经功能障碍的发生与卧立位大脑中动脉Vs和PI的变化有关,其中△Vs联合△PI可提高对自主神经功能障碍的诊断效能。

关键词: 帕金森病, 卧立位, 大脑中动脉, 脑血流变化, 自主神经功能障碍

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