Clinical Analysis And The Diagnostic Value Of Supine-standing Cerebral Blood Flow Curve To Multiple System Atrophy

Objective：Retrospective study of MSA about the clinical symptoms and thediagnostic value of supine-standing cerebral blood flow curve.Methods:Choose30cases who are likely to be clinically diagnosed of MSA.Collecting the clinical material of these patients, and make an assessment of theclinical symptoms using UMSARS at the same time. choose30healthyvolunteers (exclude cardiopulmonary diseases and influence factors such asdepression or anxiety) and20anxiety disorders as control groups.Three groupsare made to do the examination of supine-standing cerebral blood flow.Measuring the dynamic variance of cerebral blood flow velocity (CBFV) ofcases group and control groups about HR、PI、RI. And do t test parameters ofthree samples.Results:Choose30MSA patients in our hospital between January2010and March2012, whose age arrange for36-73years, with the mean age of55years old,The ration of males and females was2.33.SDS accounting for17,SNSaccounting for2,OPCA accounting for11.Original systoms were orthostatichypotension， which accounted for36.67%(11/30); Parkinson’s diseasesymptoms accounting for10.00%(3/30); Ataxia accounting for43.33%(13/30); Sexual dysfunction accounting for6.67%(2/30); Urine disorderaccounting for3.33%(1/30).In this study,there are30cases who are likely tobe clinically diagnosed of MSA, and13of them show that w wavedisappeared，18of them appear orthostatic hypotension.W wave of30cases ofhealthy controls exist.20cases of anxiety disorders made no difference between supine and standing blood pressure, but the cerebral blood flow speedcan not come back to normal.Conclusions:1、Multiple system atrophy is a sporadic chronic progressive neurodegenerationdisease，commonly appearing to people over middle-age，Morbidity is higheramong people over50years old.And males are more common than females，and the clinical manifestations are various.2、The mechanism of orthostatic hypotension for MSA patients is thatcentral pressure sensor damage. Blood pressure drops more than30/20mmHgin MSA patients with orthostatic hypotension,and some of them w wavedisappear during supine-standing cerebral blood flow. And anxiety patientsmade no difference between supine and standing blood pressure, the cerebralblood speed is not return to normal, but abnormal of w wave is rare.3、W wave disappeared in the examination of supine-standing cerebralblood flow，which is more objective than a drop of blood pressure afterstanding.So the examination of supine-standing cerebral blood flow hasimportant value of clinical application for the diagnosis of MSA.4、Transcranial color doppler ultrasonography is cheap，convenient, andcan be repeated, so supine-standing cerebral blood flow have important valueof clinical application to the diagnosis of MSA and the differential diagnosis oforthostatic hypotension.