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慢性肾衰竭所致贫血时脑血流的多普勒超声评估

Doppler sonographic evaluation of cerebral blood flow in anemia resulting from chronic renal failure.

作者信息

Haktanir Alpay, Demir Serap, Acar Murat, Ucok Kagan, Albayrak Ramazan, Yucel Aylin, Gokce Cigdem

机构信息

Department of Radiology, Afyon Kocatepe University Medical Faculty, Kirmizi Hastane, 03120 Afyon, Turkey.

出版信息

J Ultrasound Med. 2005 Jul;24(7):947-52. doi: 10.7863/jum.2005.24.7.947.

Abstract

OBJECTIVE

This study was undertaken to describe Doppler sonographic measurement of cerebral blood flow in anemia secondary to chronic renal failure and to compare the results with data gathered from healthy control subjects. We also aimed to compare vertebral and internal carotid artery blood flows to see whether any alteration of dominance in cerebral blood supply would occur.

METHODS

We studied 27 predialytic patients with chronic anemia resulting from chronic renal failure and 20 healthy control subjects by means of extracranial Doppler sonography. In these patients, blood flows of bilateral internal carotid and vertebral arteries were measured, and net vertebral artery, net internal carotid artery, and total cerebral blood flows were estimated. Statistical significance was observed between groups, and the data were correlated with hemoglobin level. Variation of the difference of the Doppler measurements between case and control groups by side (left or right) or disease status (patient or control subject) was analyzed.

RESULTS

From the assessed Doppler parameters, only cerebral blood flow and right and net vertebral artery blood flows had a significant difference between groups (P < .05) and showed a negative correlation with hemoglobin level. Vertebral artery blood flow was found to have significant interactions with disease status (P = .009) and side (P = .054).

CONCLUSIONS

Right vertebral artery blood flow is most prone to increase in chronic anemia of chronic renal failure. This effect also appears as increasing net vertebral artery blood flow and cerebral blood flow.

摘要

目的

本研究旨在描述慢性肾衰竭继发贫血时脑血流的多普勒超声测量,并将结果与健康对照者收集的数据进行比较。我们还旨在比较椎动脉和颈内动脉血流,以观察脑供血优势是否会发生任何改变。

方法

我们通过颅外多普勒超声对27例慢性肾衰竭导致慢性贫血的透析前患者和20例健康对照者进行了研究。测量这些患者双侧颈内动脉和椎动脉的血流,并估算椎动脉净血流、颈内动脉净血流和总脑血流。观察到组间有统计学意义,且数据与血红蛋白水平相关。分析病例组和对照组之间多普勒测量差值按侧(左或右)或疾病状态(患者或对照者)的变化。

结果

从评估的多普勒参数来看,仅脑血流以及右侧和椎动脉净血流在组间有显著差异(P <.05),且与血红蛋白水平呈负相关。发现椎动脉血流与疾病状态(P =.009)和侧(P =.054)有显著交互作用。

结论

在慢性肾衰竭的慢性贫血中,右侧椎动脉血流最容易增加。这种效应也表现为椎动脉净血流和脑血流增加。

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