ABSTRACT

Objectives

The goal of treatment in essential thrombocytosis (ET) is to prevent vascular complications such as thrombosis and hemorrhage. This study aimed to evaluate the risk of cerebrovascular microembolism in ET patients due to detection of microembolic signals (MES) and measure cerebral blood flow velocity (CBFV) by Transcranial Doppler (TCD) ultrasonography.

Material and Methods

In this prospective case-control study, forty patients with diagnosed ET and age and sex-matched forty healthy controls were examined by the TCD sonography.

Results

The ET group had a higher rate of MES (8/40) in the right MCA than that in the control group (none), as measured by TCD. Five patients had MES at the left MCA compared to that in no subjects in the control group. The comparison of the ET and control groups in terms of CBFV parameters showed significantly lower end-diastolic FV at the right MCA in the ET group compared to that in the control group (p < 0.05). On the other hand; both pulsatility and resistance indices in the right and left MCA and the ratios of systolic to diastolic blood flow rates in the right and left MCA were significantly higher in the ET group than that in the control group.

Discussion

This study revealed that MES seems to be more common in patients with ET despite treatment. We could suggest that ET patients should be monitored more closely to address the potential risk of developing a cerebrovascular disease, which can be estimated by detection MES and raised CBFV, combine antiplatelet therapies to standard treatments.

中文翻译：

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经颅多普勒超声检测原发性血小板增多症脑血流速度及微栓塞信号

摘要

目标

原发性血小板增多症 (ET) 的治疗目标是预防血管并发症，如血栓形成和出血。本研究旨在评估 ET 患者因检测微栓塞信号 (MES) 而发生脑血管微栓塞的风险，并通过经颅多普勒 (TCD) 超声检查测量脑血流速度 (CBFV)。

材料与方法

在这项前瞻性病例对照研究中，通过 TCD 超声检查检查了 40 名诊断为 ET 且年龄和性别匹配的 40 名健康对照患者。

结果

通过 TCD 测量，ET 组右侧 MCA 的 MES 发生率（8/40）高于对照组（无）。与对照组中没有受试者相比，5 名患者在左侧 MCA 有 MES。ET 组和对照组 CBFV 参数的比较显示，与对照组相比，ET 组右侧 MCA 的舒张末期 FV 显着降低（p <0.05）。另一方面; ET组的左右MCA的搏动和阻力指数以及左右MCA的收缩压与舒张血流量的比值均显着高于对照组。

讨论

这项研究表明，MES 似乎在接受 ET 治疗的患者中更为常见。我们建议对 ET 患者进行更密切的监测，以解决发生脑血管疾病的潜在风险，这可以通过检测 MES 和升高的 CBFV 来估计，将抗血小板治疗与标准治疗相结合。