经颅多普勒卧立位试验在脑血管病中的应用进展 Application Progress of the Recumbent-Upright Test Using Transcranial Doppler in Cerebrovascular Diseases

脑血流自动调节（cerebral autoregulation，CA）功能可维持正常脑血流灌注，对确保人正常生活及工作至关重要。CA障碍可发生在任何年龄段，在脑血管病或神经退行性疾病患者中尤为常见。TCD卧立位试验是一种运用TCD评估CA的无创、便捷方法，其关键在于监测患者从卧位到立位过程中脑血流速度和血管阻力的变化。TCD卧立位试验在脑血管病及自主神经功能障碍性疾病的诊断、治疗和预后评估方面具有重要临床应用价值，但标准化操作、结果解读和个体差异等挑战制约着其临床推广。未来，随着技术的进步和研究的深入，TCD卧立位试验有望在个体化医疗和早期诊断方面发挥更大作用。本综述旨在为更好地发挥其临床价值提供参考依据。 Abstract: Cerebral autoregulation (CA) is essential for maintaining normal cerebral blood perfusion, which is crucial for ensuring people’s normal daily life and work. CA disorders can occur at any age but are particularly common in patients with cerebrovascular diseases or neurodegenerative diseases. The recumbent-upright test using TCD is a non-invasive and convenient method to assess CA. The key is to monitor the changes in cerebral blood flow velocity and vascular resistance during the transition from supine to upright position. The recumbent-upright test using TCD has significant clinical value in the diagnosis, treatment, and prognostic assessment of cerebrovascular diseases and autonomic dysfunction. However, challenges such as standardized operation, result interpretation, and individual variability hinder its clinical application. In the future, with the advancement of technology and in-depth research, the recumbent-upright test using TCD is expected to play a greater role in individualized treatment and early diagnosis. This paper aims to provide a reference for maximizing its clinical utility.