颈内动脉超声联合经颅多普勒对产后抑郁症患者的评价研究

doi:10.3969/j.issn.1000-8535.2021.04.013

摘要/Abstract

摘要： 目的了解颈内动脉超声联合经颅多普勒对产后抑郁症患者的检测效果,为临床产后抑制治疗提供有价值的线索。方法收集本院于2018年3月—2020年2月收治的78例符合抑郁障碍诊断标准的产妇资料,对资料予以回顾研究,并设为研究组,同时另择选78例健康产妇为对照组,应用颈内动脉超声对两组产妇的颈动脉血流参数[颈动脉内径(D)、收缩期峰值流速(PSV)、舒张末期流速(EDV)以及阻力指数(RI)]进行检测,同时联合经颅多普勒超声(TCD)对两组产妇的左右大脑中(MCA)、脑前(ACA)及脑后(PCA)的动脉与椎基底动脉(VA-BA)血流速度进行监测,并分析两组产妇阻力指数(RI)与搏动指数(PI)变化,对以上数据统计分析并给予组间比较分析。结果与对照组比较,研究组D、EDV水平明显下降,而RI值升高,差异有统计学意义(P＜0.05);两组产妇的PSV比较,差异无统计学意义(P＞0.05);研究组抑郁产妇的左右大脑中(MCA)、脑前(ACA)及脑后(PCA)的动脉血流速度均加快且差异均有统计学意义(P均＜0.05);研究组抑郁产妇的椎基底动脉(VA-BA)血流速度与对照组比较减慢,差异有统计学意义(P＜0.05);研究组抑郁产妇的阻力指数(RI)与搏动指数(PI)值与对照组比较,差异均无统计学意义(P＞0.05);78例抑郁产妇中,62例呈现脑动脉血流异常。检测异常率为79.49%(62/78)。结论经颅多普勒检测,可见产后抑郁产妇的3条脑动脉血流速度明显加快,而椎基底动脉血流减缓,由此提示抑郁产妇脑动脉痉挛且脑供血明显不足,颈内动脉超声显示抑郁产妇的颈动脉血流参数有一定变化,能够为产后抑郁患者的治疗提供一定参考。

关键词: 经颅多普勒超声, 抑郁症, 产妇, 脑动脉血流, 颈动脉血流参数, 颈内动脉超声

Abstract: Objective To understand the detection effect of internal carotid artery ultrasound combined with transcranial Doppler on patients with postpartum depression, and to provide valuable clues for clinical postpartum depression treatment. Methods The data of 78 parturients who met the diagnostic criteria for depression in our hospital from March 2018 to February 2020 were collected. The data were reviewed and set as the study group. At the same time, 78 healthy parturients were selected as the control group.We used internal carotid artery ultrasound to detect the carotid blood flow parameters [carotid artery diameter (D), peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance index (RI)] of the two groups of parturients, and combined transcranial color Doppler ultrasound (TCD) to monitor the blood flow velocity of the arteries and vertebrobasilar artery (VA-BA), middle cerebral artery (MCA), anterior cerebral artery (ACA) and posterior cerebral artery (PCA) of the two groups of women. The changes in maternal RI and PI between the two groups were analyzed, and the above data were statistically analyzed and compared between groups. Results Compared with the control group, the D and EDV levels of the study group were decreased, while the RI value was increased, the difference was statistically significant (P<0.05). The comparison of PSV between the two groups was not statistically significant (P>0.05). The arterial blood flow velocity in MCA, ACA, and PCA of the depressed women in the study group were accelerated and the differences were statistically significant (P<0.05). The blood flow velocity of VA-BA of the depressed women in the study group was slower than that of the control group, and the difference was statistically significant (P＜0.05). RI and PI values of depressed women in the study group were compared with those of the control group. There was no statistically significant difference between the groups (P>0.05). Among 78 depressed women, 62 had abnormal cerebral artery blood flow. The abnormal detection rate was 79.49% (62/78). Conclusion Transcranial Doppler examination showed that the blood flow of the three cerebral arteries of the postpartum depressed women was increased, while the blood flow of the vertebrobasilar arteries slowed down, which indicated that the depressed women had cerebral artery spasm and the cerebral blood supply was obviously insufficient. The internal carotid artery ultrasound showed there were certain changes in carotid blood flow parameters of depressed mothers, which can provide a certain reference for the treatment of patients with postpartum depression.

Key words: Transcranial Doppler ultrasound, Depression, Parturient, Cerebral arterial blood flow, Carotid blood flow parameters, Internal carotid artery ultrasound

樊建凤, 罗碧, 李志杰. 颈内动脉超声联合经颅多普勒对产后抑郁症患者的评价研究[J]. 广州医药, 2021, 52(4): 60-64.

FAN Jianfeng, LUO Bi, LI Zhijie. Evaluation of internal carotid artery ultrasound combined with transcranial Doppler in patients with postpartum depression[J]. Guangzhou Medical Journal, 2021, 52(4): 60-64.

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