Korean Journal of Clinical Laboratory Science (대한임상검사과학회지)

Korean Society for Clinical Laboratory Science (대한임상검사과학회)
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Factors Affecting Basilar Artery Pulsatility Index on Transcranial Doppler

뇌혈류 초음파 검사에서 기저동맥 박동지수에 영향을 미치는 인자

  • Jeong, Ho Tae (Department of Neurology, Chung-Ang University Hospital, Department of Medicine (Major in Neurology), Chung-Ang University Graduate School) ;
  • Kim, Dae Sik (Department of Clinical Laboratory Science, Dongnam Health University) ;
  • Kang, Kun Woo (Department of Neurology, Samsung Medical Center) ;
  • Nam, Yun Teak (Department of Neurology, National Health Insurance Ilsan Hospitall) ;
  • Oh, Ji Eun (Department of Biomedical Laboratory Science, Far East University) ;
  • Cho, Eun Kyung (Department of Clinical Laboratory Science, Dongnam Health University)
  • 정호태 (중앙대학교병원 신경과, 중앙대학교 일반대학원 의학과 신경과학) ;
  • 김대식 (동남보건대학교 임상병리과) ;
  • 강건우 (삼성서울병원 신경과) ;
  • 남윤택 (국민건강보험 일산병원 신경과) ;
  • 오지은 (극동대학교 임상병리과) ;
  • 조은경 (동남보건대학교 임상병리과)
  • Received : 2018.10.11
  • Accepted : 2018.11.04
  • Published : 2018.12.31
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Abstract

Transcranial doppler is a non-invasive method that measures the blood flow velocity and the direction of cerebral blood vessels through the doppler principle. The pulsatility index is an index for measuring the transcranial doppler that reflects the distal vascular resistance and is used as an index for the presence and diffusion of cerebral small vessel diseases. The purpose of this study was to evaluate the risk factors affecting the basilar artery pulsatility index in ischemic stroke patients. From January 2014 to May 2015, 422 patients were selected by measuring the transcranial doppler pulsatility index, considering their basilar artery pulsatility index. Univariate analysis was performed using the basilar artery pulsatility index as a dependent variable. Multiple regression analysis was performed considering the factors affecting the pulsatility index as variables. Univariate analysis revealed age, presence of hypertension, presence of diabetes mellitus, presence of hyperlipidemia, and hematocrit (P<0.1) as factors. Multiple regression analysis showed statistically significant results with age (P<0.001), presence of diabetes (P=0.004), and presence of hyperlipidemia (P=0.041). The risk factors affecting the basilar artery pulsatility index of transcranial doppler were age, diabetes, and hyperlipidemia. Further research will be needed to increase the cerebral pulsatility index as a surrogate marker of the elderly, diabetes, and hyperlipidemia.

뇌혈류 초음파 검사는 비침습적인 방법으로 대뇌 혈관 혈류 속도와 방향을 도플러 원리로 측정하는 검사이다. 뇌혈류 초음파 검사의 박동지수는 원위부 혈관 저항을 반영하는 측정 지표이며 대뇌 소혈관 질환 발생과 확산지표로 사용되고 있다. 본연구의 목적은 허혈성 뇌졸중 환자에서 기저 동맥의 박동지수에 영향을 미치는 위험 인자를 평가하는데 있다. 2014년 1월부터 2015년 5월까지 내원 환자를 대상으로 뇌혈류 초음파 검사 박동지수를 측정하여 기저동맥 박동지수 대상자 422명을 선정하였다. 기저동맥 박동지수를 종속변수로 하여 단변량 분석을 실시하였고, 박동지수에 영향을 미치는 인자를 변수에 특징을 고려하여 다중회귀 분석을 실시하였다. 단변량 분석 결과 박동지수에 영향을 미치는 인자는 연령, 고혈압 유무, 당뇨 유무, 고지혈증 유무, 적혈구용적으로 나타났다(P<0.1) 다중회귀분석을 실시한 결과 연령(P<0.001), 당뇨 유무(P=0.004), 고지혈증 유무(P=0.041)가 통계적으로 유의한 결과를 보였다. 뇌혈류 초음파 검사의 박동지수에 영향을 미치는 위험인자는 고령, 당뇨, 고지혈증이다. 이후 추가적인 연구를 통하여 두 개 내 박동지수 증가는 고령, 당뇨, 고지혈증을 반영하는 지표로 활용 될 수 있을 것으로 생각된다.

Keywords

References

  1. Wechsler LR, Babikian VL. Transcranial Doppler sonography:clinically useful. Arch Neurol. 1994;51:1054-1056. https://doi.org/10.1001/archneur.1994.00540220102021
  2. Tripp LD, Warm JS. Transcranial doppler sonography. In: Raja P, Matthew R, editors. Neuroergonomics: The brain at work. 1st ed. New York; Oxford university press; 2007. p82-94.
  3. Aaslid R. Transcranial doppler sonography. 1st ed. New York:Springer science & business media; 2012.
  4. Gosling R, King D. The role of measurement in peripheral vascular surgery: arterial assessment by Doppler-shift ultrasound. 1st ed. Amsterdam: SAGE publications; 1974. p447-449.
  5. Bellner J, Romner B, Reinstrup P, Kristiansson KA, Ryding E, Brandt L. Transcranial Doppler sonography pulsatility index (PI) reflects intracranial pressure (ICP). Surg Neurol. 2004;62:45-51. https://doi.org/10.1016/j.surneu.2003.12.007
  6. Kidwell CS, El-Saden S, Livshits Z, Martin NA, Glenn TC, Saver JL. Transcranial Doppler pulsatility indices as a measure of diffuse small-vessel disease. J Neuroimaging. 2001;11:229-235. https://doi.org/10.1111/j.1552-6569.2001.tb00039.x
  7. Lee WJ, Jung KH, Ryu YJ, Lee KJ, Kim JM, Lee ST, et al. Progression of cerebral white matter hyperintensities and the associated sonographic index. Radiology. 2017;284:824-833. https://doi.org/10.1148/radiol.2017162064
  8. Park KY, Chung PW, Kim YB, Moon HS, Suh BC, Yoon WT. Increased pulsatility index is associated with intracranial arterial calcification. Eur Neurol. 2013;69:83-88. https://doi.org/10.1159/000342889
  9. Hatano S. Experience from a multicentre stroke register: a preliminary report. Bull World Health Organ. 1976;54:541.
  10. Lee YS, Yoon BW, Roh JK. A clinical study of transient ischemic attacks preceding cerebral infarcts. J Korean Neurol Assoc. 1996;14:9-16.
  11. Lee KY, Sohn YH, Baik JS, Kim GW, Kim JS. Arterial pulsatility as an index of cerebral microangiopathy in diabetes. Stroke. 2000;31:1111-1115. https://doi.org/10.1161/01.STR.31.5.1111
  12. Ackerstaff R, Keunen R, Pelt W, Swijndregt AM, Stijnen T. Influence of biological factors on changes in mean cerebral blood flow velocity in normal ageing: a transcranial doppler study. Neurol Res. 1990;12:187-191. https://doi.org/10.1080/01616412.1990.11739941
  13. Cho SJ, Sohn YH, Kim GW, Kim JS. Blood flow velocity changes in the middle cerebral artery as an index of the chronicity of hypertension. J Neurol Sci. 1997;150:77-80. https://doi.org/10.1016/S0022-510X(97)05391-4
  14. Lee KO, Park JH, Choi YC, Han SW, Nam HS, Heo JH, et al. Increased pulsatility index in acute lacunar infarction with type II diabetes. J Korean Neurol Assoc. 2005;23:457-462.
  15. Sharma VK, Tsivgoulis G, Lao AY, Malkoff MD, Alexandrov AV. Noninvasive detection of diffuse intracranial disease. Stroke. 2007;38:3175-3181. https://doi.org/10.1161/STROKEAHA.107.490755
  16. Lim M-H, Cho YI, Jeong SK. Homocysteine and pulsatility index of cerebral arteries. Stroke. 2009;40:3216-3220. https://doi.org/10.1161/STROKEAHA.109.558403
  17. Park JS, Kim CS, Kim HJ, Nam JS, Noh TW, Ahn CW, et al. Relation between cerebral arterial pulsatility and insulin resistance in type 2 diabetic patients. J Korean Diabetes. 2006; 30:347-354. https://doi.org/10.4093/jkda.2006.30.5.347
  18. Isikay CT, Uzuner N, Gucuyener D, Ozdemir G. The effects of hematocrit and age on transcranial Doppler measurements in patients with recent ischemic stroke. Neurol India. 2005;53:51. https://doi.org/10.4103/0028-3886.15055