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首页> 外文期刊>Journal of Clinical Ultrasound: JCU >Transcranial Doppler ultrasound assessment of intracranial hemodynamics in children with diabetic ketoacidosis.
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Transcranial Doppler ultrasound assessment of intracranial hemodynamics in children with diabetic ketoacidosis.

机译：经颅多普勒超声评估糖尿病酮症酸中毒患儿的颅内血流动力学。

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摘要

The pathophysiology of acute neurological complications of diabetic ketoacidosis (DKA) in children and adolescents is not completely understood. We sought to establish whether transcranial Doppler (TCD) was able to monitor the changes of cerebral blood flow regulatory mechanisms, as measured by cerebral blood velocities (CBF-V), Gosling's pulsatility index (PI), and cerebral vascular reactivity (VR), prior to and during treatment of DKA. The increased values of PI suggested an increase of intracranial pressure (ICP) due to the existence of cerebral vasoparalysis, based on the low values of VR prior to treatment and 6 hours after initiation of treatment. At 24 hours, the correction of hematocrit and pH was associated with a significant decrease of PI, suggesting a decrease of ICP, likely due to a return of vascular tone in response to the low PaCO2. This was further supported by an increase of VR in all patients. At 48 hours, when PaCO2 returned to normal, the PI remained low and the VR increased further, suggesting a complete reversal of vasoparalysis and a return of cerebral blood flow regulatory mechanisms.
机译：儿童和青少年糖尿病性酮症酸中毒（DKA）的急性神经系统并发症的病理生理学尚未完全了解。我们试图确定经颅多普勒（TCD）是否能够监测脑血流调节机制的变化，该变化通过脑血流速度（CBF-V），高斯林搏动指数（PI）和脑血管反应性（VR）来衡量，在DKA治疗之前和治疗期间。基于治疗前和治疗后6小时的VR值较低，PI值的升高表明由于脑血管麻痹的存在，颅内压（ICP）升高。在24小时时，血细胞比容和pH值的校正与PI的显着降低有关，表明ICP的降低，这可能是由于低PaCO2引起的血管张力恢复所致。所有患者中VR的增加进一步支持了这一点。在第48小时，当PaCO2恢复正常时，PI仍然很低，VR进一步升高，表明血管麻痹完全逆转并且脑血流调节机制恢复。

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