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首页> 外文期刊>Journal of Clinical Ultrasound: JCU >Cerebral autoregulation in hemorrhagic stroke: A systematic review and meta-analysis of transcranial Doppler ultrasonography studies
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Cerebral autoregulation in hemorrhagic stroke: A systematic review and meta-analysis of transcranial Doppler ultrasonography studies

机译：出血性中风中的脑自身调节：经颅多普勒超声研究的系统审查和荟萃分析

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Purpose International guidelines advocate intensive blood pressure (BP) lowering within 6 hours of acute intracerebral hemorrhage (ICH) to a target systolic BP of 130-140 mm Hg, though more intensive lowering may be associated with adverse outcome. Observational studies suggest impaired cerebral autoregulation (CA) following ICH. Transcranial Doppler ultrasonography (TCD), alongside continuous BP monitoring, provides a noninvasive bedside investigation that offers detailed perspectives on physiological perturbations post-acute ICH. This systematic review and meta-analysis focuses on all TCD studies of CA in ICH. Methods MEDLINE, EMBASE, and CENTRAL were searched for studies of hemorrhagic stroke and blood flow measurement. Results Eight studies met inclusion criteria (293 ICH patients); CA was impaired up to 12-days post-acute ICH. Impaired CA was evidenced by reduced transfer function analysis phase and higher mean flow correlation values: these were associated with worsened clinical parameters including ICH-volume and Glasgow Coma Scale. Meta-analysis of CBV demonstrated that, compared to controls, mean CBV was significantly lower in the ipsilateral (49.7 vs 64.8 cm s(-1), Z = 4.26, P .0001) and contralateral hemispheres following ICH (51.5 vs 64.8 cm s(-1), Z = 3.44, P = .0006). Conclusion Lower mean CBV in combination with impaired CA may have implications for more intensive BP lowering and warrants further studies examining such strategies on cerebral blood flow and its regulatory mechanisms.
机译：目的国际指南倡导强化血压（BP）在急性脑出血（ICH）的6小时内降低到130-140毫米HG的靶收缩性BP，尽管更加强烈降低可能与不利的结果有关。观察性研究表明脑自动调节（CA）之后的损伤。经颅多普勒超声检查（TCD），连续BP监测，提供了一种非侵入性床头旁，提供了关于急性ICH后生理扰动的详细视角。这种系统审查和荟萃分析侧重于ICH中CA的所有TCD研究。方法搜索杂志，Embase和Central的出血性卒中和血流测量的研究。结果八项研究符合纳入标准（293名患者）; CA损害至急性急性急性后12天。通过减少的转移函数分析阶段和更高的平均流量相关值证明了缓冲的Ca：这些与临床参数恶化，包括ICH体积和Glasgow Coma规模相关。 CBV的Meta分析证明，与对照相比，IPsilAtalal（49.7 Vs 64.8cm S（-1），Z = 4.26，P＆lt中剖腹脉的平均CBV显着较低（51.5 Vs 64.8 cm s（-1），z = 3.44，p = .0006）。结论较低的平均CBV与受损的CA组合可能对更强化的BP降低有影响，并认证进一步研究检查脑血流和其调节机制的这种策略。

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