TCD Was Used To Evaluate The Clinical Value Of Cerebral Hemodynamic Changes In Drug Addict Patients

Objective:To explore the changes of cerebral hemodynamics in methamphetamine and heroin addicts during difference of abstinence time.Methods:Part 1 We recorded cerebral blood flow velocity by transcranial Doppler(TCD)in new entry into the drug detoxification station methamphetamine dependent subjects(n=27)and in control subjects(n=23)to analyze the results.Blood flow velocity was recorded within 3 days of admission and 28 to 30 days of monitored abstinence.The data were listed as before and after abstinence before and after comparison,and compared with the normal control group.Part 2 57 patients with heroin addicts were included,28 of whom had a abstinence time of less than 6 months(short-term abstinence group)and 29 of whom had a abstinence time greater than 12 months(long-term abstinence group),23 subjects with matching demographic data(normal control group).Use the TCD instrument to detect the blood flow parameters of the subject's cerebral blood vessels and compare the results.Pearson correlation analysis was used to analyze the relationship between the statistically significant differences between the three groups and the abstinence time.Results:Part 1 Pulsatility index(PI),peak systolic velocity(Vp)and mean velocity(Vm)were significantly increased in the methamphetamine users vs control subjects in the anterior(ACA)and middle(MCA)cerebral arteries(P<0.05),PI and Vp were significantly increased in the posterior(PCA)cerebral artery(P<0.05),PI were significantly increased in the vertebral(VA)cerebral artery(P<0.05),the blood flow velocity was no significant difference in basilar(BA)artery(P>0.05).Methamphetamine users had decreased Vp and PI in the MCA,decreased Vp?Vm and PI in the ACA,decreased Vp in the PCA after a month of monitored abstinence(P<0.05),the blood flow velocity was no significant difference in VA and BA(P>0.05).Part 2 The difference of abstinence time between the short-term abstinence group and the long-term abstinence group was statistically significant(P<0.05).The hemodynamics with statistically significant differences(P<0.05)between the 3 groups included Vp and PI in the MCA,PI in the ACA,Vd and PI in the PCA,Vp?Vm and PI in the VA.The Vp in the MCA in the short-term abstinence group was significantly increased compared to control subjects.The PI in the middle,anterior and posterior cerebral arteries and vertebral arteries in the short-term abstinence group was significantly increased compared to long-term abstinence group and control group.Meanwhil,the PI in the MCA?AC A and VA in the long-term abstinence group was increased compared to control subjects.The Vd in the PCA of the control group was increased compared to the short-term and long-term abstinence group.The Vp and Vm of the VA in the short-term abstinence group was increased compared to long-term abstinence group and control group.In heroin addicts,the middle cerebral artery PI(r=-0.19,P=0.034),vertebral artery Vp(r=-0.24,P=0.01)and vertebral artery PI(r=-0.19,P=0.041)were negatively correlated with abstinence duration.Conclusions:1.Long-term chronic use of methamphetamine or heroin can lead to abnormal perfusion of cerebral hemodynamics and partial improvement after a period of withdrawal.2.Abnormal cerebral hemodynamic perfusion of methamphetamine or heroin can provide evidence for central nervous system injury caused by drug abuse.3.TCD is rapid,economical,non-invasive and repeatable.It can be used to evaluate the cerebral hemodynamic changes of drug addicts,assist in judging the conditions of drug addicts,and has certain clinical value in guiding drug treatment.