臂踝指数检测对锁骨下动脉重度狭窄的诊断价值  

Diagnostic value of measuring brachial ankle index in serious stenosis of subclavian artery

作　　者：张雄伟[1] 张以善[1] 王磊[1] 黄艾华[1] 史杰[1] 尹世敏[1] 王翠玉[1] 李曼[1] 

机构地区：[1]第二炮兵总医院神经内科,北京100088

出　　处：《中华老年心脑血管病杂志》2009年第12期962-964,共3页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的探讨臂踝指数检测对锁骨下动脉重度狭窄的诊断价值。方法选择经数字减影血管造影和(或)CT血管成像证实的锁骨下动脉重度狭窄老年患者48例(狭窄组),另选择无锁骨下动脉病变患者50例(对照组)。采用无创伤全自动外周动脉检测仪测量臂踝指数、两侧肱动脉收缩压差、脉搏波上行时间和脉搏波形。结果狭窄组患侧肢体的臂踝指数明显低于健侧肢体和对照组;狭窄组患侧肢体的脉搏波上行时间较健侧肢体和对照组明显延迟,差异有统计学意义。狭窄组两侧肱动脉收缩压差与对照组比较差异有统计学意义(P<0.01)。狭窄组患侧肢体的脉搏波形呈低钝波40倒(83%),呈低平波8例(17%)。结论检测臂踝指数等参数有助于快速筛查和诊断锁骨下动脉重度狭窄,为临床寻找后循环缺血的原因和更深入研究缺血性脑血管病的发病机制提供重要依据。Objective To explore diagnostic value of measuring braehial ankle index（BAD in the serious stenosis of subclavian artery. Methods In 48 aged patients（patient group） with serious stenosis of subclavian artery determined by digital subtraction or CT angiography, measurement of BAI,systolic pressure difference of bilateral brachial arteries, upstroke time of pulse wave and pulse waveforms was performed with a non-invasive automatic peripheral arterial device. Fifty patients without disease of subclavian artery were selected to serve as controls. Results In the patient group,BAI of upper arm with stenosis was significantly lower than that of the upper arm without stenosis and control group. Upstroke time of pulse wave of upper arm with stenosis was significantly longer than that of the upper arm without stenosis and control group. There was significant difference in systolic pressure difference of bilateral brachial arteries between the patient group and the control group （P 〈 0.01）. In patient group,the low blunt waveform of upper arm with stenosis was found in 40 patients（83%）,flat waveform was found in 8 patients（17%）. Conclusions Measuring BAI might further help to quickly diagnose the serious stenosis of subclavian artery,provide important and objective basis for discovering the cause of posterior circulation isehemia and for exploring deeply the pathogenesis of ischemie cerebrovascular disease.

关 键 词：锁骨下动脉窃血综合征 血管造影术 数字减影 血压测定 四肢 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]