Correlation between transcranial Doppler ultrasound measurements of the middle cerebral artery and consciousness score and blood biochemical indexes in patients after craniotomy

doi:10.11817/j.issn.1673-9248.2023.03.005

Abstract

Abstract:

Objective

To evaluate the correlation of consciousness score, blood biochemical indicators, and transcranial Doppler ultrasound measurements, and to explore the role of assessing the middle cerebral artery status in patients after the craniotomy to guide clinical decision-making.

Methods

82 patients who underwent craniotomy in the neurological intensive care unit of the First Affiliated Hospital of Xinjiang Medical University from January 2019 to January 2021, were retrospectively collected. The demographic information, admission assessment [including Glasgow Coma Score (GCS) and Acute Physiological and Chronic Health Evaluation (APACHE Ⅱ)], laboratory test indexes, arterial blood gas results, transcranial Doppler ultrasound measurement values, primary vital signs, and the correlation between the observed indexes and the pulsatility index (PI) and resistance index (RI) was analyzed by univariate and multivariate linear regression.

Results

GCS (regression coefficient=0.009, P=0.038), APACHE Ⅱ (regression coefficient=0.009, P＜0.001), PI (regression coefficient=0.070, P＜0.001) were linear correlated with RI. The pH value (regression coefficient=-5.328, P=0.007) and RI (regression coefficient=6.630, P＜0.001) were linearly correlated with PI.

Conclusion

Indirect assessment of middle cerebral artery vascular elasticity, resistance, and blood flow by GCS, APACHE Ⅱ, and pH can be attempted in the clinic to guide clinical decision-making further.

Key words: Transcranial Doppler ultrasound, Resistance index, Pulsatility index, Intensive care unit, Middle cerebral artery

Yongkai Li, Tuerxun Tuerhong, Jianzhong Yang. Correlation between transcranial Doppler ultrasound measurements of the middle cerebral artery and consciousness score and blood biochemical indexes in patients after craniotomy[J]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2023, 17(03): 221-226.

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Figures/Tables 8

影响因素	数值	RI		PI
影响因素	数值	r值	P值	r值	P值
基本信息
年龄（岁， $x ¯$ ±s）	49.98±14.91	9.286	0.003	4.462	0.038
男/女（例）	46/36	0.874	0.353	0.184	0.669
入院评估
GCS[分，M（Q_R）]	11.00（8.00，13.00）	3.413	0.068	4.287	0.042
APACHE Ⅱ[分，M（Q_R）]	12.00（8.00，16.00）	11.488	0.001	4.460	0.038
实验室检查指标
pH值[M（Q_R）]	7.45（7.41，7.47）	8.358	0.005	16.901	＜0.001
PCO₂（mmHg， $x ¯$ ±s）	34.88±5.88	3.130	0.081	0.900	0.346
PO₂[mmHg，M（Q_R）]	133.00（104.00，157.50）	1.984	0.163	0.087	0.769
甘油三酯[mmol/L，M（Q_R）]	1.16（0.88，1.63）	0.165	0.686	0.138	0.712
胆固醇[mmol/L，M（Q_R）]	3.83（3.24，4.46）	0.057	0.812	0.178	0.674
高密度脂蛋白[mmol/L，M（Q_R）]	1.00（0.78，1.30）	0.430	0.514	0.071	0.790
低密度脂蛋白[mmol/L，M（Q_R）]	2.35（1.89，3.41）	0.119	0.731	0.006	0.939
TCD测量数值
Vp（cm/s， $x ¯$ ±s）	90.35±29.03	22.251	0.001	16.305	＜0.001
Vm[cm/s，M（Q_R）]	53.00（42.00，68.50）	69.430	0.001	27.640	＜0.001
Vd[cm/s，M（Q_R）]	36.00（26.50，45.00）	118.896	0.001	28.740	＜0.001
PI[M（Q_R）]	0.99（0.81，1.20）	90.351	0.001	-	-
RI[M（Q_R）]	0.60（0.53，0.67）	-	-	90.351	0.001
基本生命体征
体温[℃，M（Q_R）]	37.40（36.60，37.85）	0.565	0.454	0.144	0.705
心率（次/min， $x ¯$ ±s）	82.65±15.09	0.744	0.391	0.576	0.450
收缩压（mmHg， $x ¯$ ±s）	135.65±20.79	0.022	0.884	1.248	0.267
舒张压（mmHg， $x ¯$ ±s）	73.68±13.99	1.038	0.311	1.716	0.194
呼吸频率[次/min，M（Q_R）]	15.00（15.00，18.00）	0.001	0.989	0.001	0.970
SpO₂[%，M（Q_R）]	99.00（98.00，100.00）	2.332	0.131	1.347	0.249

影响因素	数值	RI		PI
影响因素	数值	r值	P值	r值	P值
基本信息
年龄（岁， $x ¯$ ±s）	49.98±14.91	9.286	0.003	4.462	0.038
男/女（例）	46/36	0.874	0.353	0.184	0.669
入院评估
GCS[分，M（Q_R）]	11.00（8.00，13.00）	3.413	0.068	4.287	0.042
APACHE Ⅱ[分，M（Q_R）]	12.00（8.00，16.00）	11.488	0.001	4.460	0.038
实验室检查指标
pH值[M（Q_R）]	7.45（7.41，7.47）	8.358	0.005	16.901	＜0.001
PCO₂（mmHg， $x ¯$ ±s）	34.88±5.88	3.130	0.081	0.900	0.346
PO₂[mmHg，M（Q_R）]	133.00（104.00，157.50）	1.984	0.163	0.087	0.769
甘油三酯[mmol/L，M（Q_R）]	1.16（0.88，1.63）	0.165	0.686	0.138	0.712
胆固醇[mmol/L，M（Q_R）]	3.83（3.24，4.46）	0.057	0.812	0.178	0.674
高密度脂蛋白[mmol/L，M（Q_R）]	1.00（0.78，1.30）	0.430	0.514	0.071	0.790
低密度脂蛋白[mmol/L，M（Q_R）]	2.35（1.89，3.41）	0.119	0.731	0.006	0.939
TCD测量数值
Vp（cm/s， $x ¯$ ±s）	90.35±29.03	22.251	0.001	16.305	＜0.001
Vm[cm/s，M（Q_R）]	53.00（42.00，68.50）	69.430	0.001	27.640	＜0.001
Vd[cm/s，M（Q_R）]	36.00（26.50，45.00）	118.896	0.001	28.740	＜0.001
PI[M（Q_R）]	0.99（0.81，1.20）	90.351	0.001	-	-
RI[M（Q_R）]	0.60（0.53，0.67）	-	-	90.351	0.001
基本生命体征
体温[℃，M（Q_R）]	37.40（36.60，37.85）	0.565	0.454	0.144	0.705
心率（次/min， $x ¯$ ±s）	82.65±15.09	0.744	0.391	0.576	0.450
收缩压（mmHg， $x ¯$ ±s）	135.65±20.79	0.022	0.884	1.248	0.267
舒张压（mmHg， $x ¯$ ±s）	73.68±13.99	1.038	0.311	1.716	0.194
呼吸频率[次/min，M（Q_R）]	15.00（15.00，18.00）	0.001	0.989	0.001	0.970
SpO₂[%，M（Q_R）]	99.00（98.00，100.00）	2.332	0.131	1.347	0.249

影响因素	B值	标准误	β值	95%CI	t值	P值
常量	0.321	0.074	-	0.174~0.469	4.349	＜0.001
GCS	0.009	0.004	0.232	0.000~0.018	2.106	0.038
APACHE Ⅱ	0.009	0.003	0.369	0.004~0.015	3.343	＜0.001
PI	0.070	0.007	0.696	0.055~0.084	9.316	＜0.001
年龄	0.001	0.001	0.135	0.000~0.003	1.772	0.08
pH值	-0.067	0.232	-0.027	-0.530~0.396	-0.288	0.774
PCO₂	0.003	0.002	0.125	-0.001~0.007	1.538	0.128

影响因素	B值	标准误	β值	95%CI	t值	P值
常量	36.836	14.486	-	8.001~65.670	2.543	0.013
pH值	-5.328	1.927	-0.214	-9.164~-1.491	-2.764	0.007
RI	6.630	0.774	0.662	5.088~8.171	8.562	＜0.001
年龄	0.006	0.008	0.058	-0.010~0.021	0.734	0.465
GCS	-0.088	0.043	-0.227	-0.175~-0.002	-2.037	0.050
APACHE Ⅱ	-0.037	0.030	-0.147	-0.095~0.022	-1.237	0.220

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