经颅多普勒超声评估动态脑血流自动调节在急性缺血性脑卒中个体化血压管理中的研究进展OA

Blood pressure management after acute ischemic stroke(AIS)is a core clinical issue.Abnormal blood pressure fluctuations can exacerbate brain injury and affect neurological functional outcomes.Current population-based guideline recommendations cannot fully capture the individual differences in patients'cerebral blood flow regulation capacity,making it difficult to establish precise blood pressure control targets.Dynamic cerebral autoregulation(dCA)plays a central role in maintaining cerebral perfusion homeostasis,and its dynamic assessment provides a new direction for personalized blood pressure management in AIS patients.Transcranial Doppler ultrasound(TCD)offers advantages such as being non-invasive,real-time,repeatable at the bedside,and having high temporal resolution,making it an important tool for assessing dCA function.This article systematically reviews the technical methods and physiological basis of using TCD to assess dCA,with a focus on the application value of TCD-related parameters in identifying cerebral perfusion regulation capacity after AIS and exploring individualized optimal blood pressure ranges.It also summarizes the clinical evidence,translational barriers,and future research directions in blood pressure management of AIS.TCD-based dCA assessment holds promise for providing a decision-making basis that better aligns with pathophysiological characteristics for individualized blood pressure management in AIS patients.However,its routine clinical application still requires further standardization of the assessment process and awaits validation through high-quality clinical studies.