急性脑梗死患者治疗后MCA血流速度的变化及影响因素

The Influence Factors of Blood Flow Velocity Changes of Middle Cerebral Artery in Patients with Cerebral Infarction after Treatment

目的:探讨急性脑梗死(ACI)患者治疗后大脑中动脉(MCA)血流速度的影响因素。方法:58例ACI患者,根据入院治疗1周时MCA血流速度分为血流速度升高组和血流速度降低组,两组患者治疗方法相同,记录2组ACI患者入院时和治疗1周时全血红细胞(RBC)、白细胞(WBC)、平均血红蛋白含量(MCH)、平均血红蛋白浓度(MCHC)、血小板计数(PLT)和全血黏度、血浆黏度、纤维蛋白原及血沉(ESR);采用Pearson分析治疗1周时ACI患者MCA血流速度与全血黏度、血浆黏度和纤维蛋白原相关性,并以MCA血流速度作为因变量(升高=0,减低=1),全血黏度、血浆黏度和纤维蛋白原作为自变量进行非条件Logistic回归分析。结果:两组ACI患者治疗前RBC、WBC、MCH、MCHC、PLT、全血黏度、血浆黏度、纤维蛋白原及ESR比较,差异无统计学意义(P>0.05),治疗后1周时,A组全血黏度、血浆黏度和纤维蛋白原明显低于B组(P<0.05);而RBC、WBC、MCH、MCHC、PLT及血沉比较差异无统计学意义(P>0.05);Pearson相关分析结果显示MCA血流速度与全血黏度、血浆黏度和纤维蛋白原呈负相关关系(r=-0.233,-0.252,-0.248,P<0.05);非条件Logistic回归分析结果显示全血黏度、血浆黏度和纤维蛋白原是ACI患者治疗后MCA血流速度变化的危险因素。结论:ACI患者治疗后MCA血流速度改善与血液黏度有关。

Objective： To investigate the influence factors of blood flow velocity changes of middle cerebral artery （MCA） in acute cerebral infarction （ACI） patients after treatment. Methods： Accord- ing to MCA blood flow velocity in one week after treatment, 58 ACI patients were divided into blood flow velocity increase group （group A） and blood flow velocity decrease group （group B） . Patients in the two groups accepted the same treatment. RBC, WBC, MCH, MCHC, Ph, whole blood viscosity, plasma viscosity, fibrinogen and ESR were detected. The relationship of MCA blood flow velocity with whole blood viscosity, plasma viscosity and fibrinogen was analyzed. Non conditional Logistic regres- sion analysis was carried out using MCA flow velocity as the dependent variable, the whole blood vis- cosity, plasma viscosity and fibrinogen as independent variables. Results： Before treatment, the differences of RBC, WBC, MCH, MCHC, Plt, whole blood viscosity, plasma viscosity, fibrinogen and ESR between the two groups had no statistical significance （P 〉 0.05 ） ; one week after treatment, levels of whole blood viscosity, plasma viscosity and fibrinogen in group A were significantly lower than those in B group （ P 〈 0.05 ） but RBC,WBC, MCH, MCHC, Pit, ESR showed no statistical differ-ence （P 〉 0.05 ）. MCA flow velocity were negatively correlated with whole blood viscosity, plasma viscosity and fibrinogen （r = - 0. 233, - 0. 252, - 0. 248, P 〈 0.05 ）. Non conditional Logistic re- gression analysis results showed that the whole blood viscosity, plasma viscosity and fibrinogen were risk factors of MCA blood flow velocity changes after treatment in patients with ACI. Conclusion： Im- provement of MCA blood flow velocity in patients with ACI relate to blood viscosity after treatment.