颈性眩晕的椎动脉孔内段(V_2段)血管形态病理学改变  

The Patho-morphological Change of the Cervical Transverse Foramen Segment of Vertebral Artery Related with Cervical Vertigo

作　　者：范炳华[1] 许丽[1] 林敏[1] 李伟[2] 汪芳俊[3] 徐泉珍[1] 

机构地区：[1]浙江中医药大学附属第三医院,杭州310005 [2]浙江医院 [3]浙江省中西医结合医院

出　　处：《浙江中医药大学学报》2015年第1期1-5,共5页Journal of Zhejiang Chinese Medical University

基　　金：国家临床重点专科建设项目(国卫医发2013-42号);浙江省范炳华名老中医专家传承工作室(GZS2012016);国家中医药管理局中医药科技专项课题(06-07LP21);浙江省中医药管理局重点项目(2008ZA007)~~

摘　　要：[目的]探索颈性眩晕与椎动脉孔内段(V2段)血管形态病理学改变的关系。[方法]回顾1999年至2011年以眩晕为主症,符合颈性眩晕临床诊断,经颅多普勒检测有椎-基底动脉血流速增快或减慢的患者1680例,采用椎-基底动脉CT血管造影三维重建技术(3D-CTA),获得椎-基底动脉血管形态影像资料,观察和分析椎动脉V2段血管形态病理学改变表现。[结果]1680例颈性眩晕患者中,椎动脉孔内段(V2段)血管形态病理学改变者336例(20.0%)。其中,椎动脉V2段血管纤细218例(64.9%);椎动脉血管缺如21例(6.3%);椎动脉血管受压56例(16.7%);椎动脉血管受纤维束带牵拉40例(11.9%);椎动脉血管双支畸形1例(0.3%)。[结论]颈性眩晕患者的椎动脉孔内段(V2段)血管存在5种形态病理学改变,以椎动脉血管纤细发生率最高,椎动脉血管双支畸形发生率最低。研究结果对颈性眩晕的诊断、治疗措施选择、预后判断、指导患者自我防护等方面有积极意义。[Objective] To explore the pathomorphological change of the cervical transverse foramen segment of vertebral artery（V2part） related with cervical vertigo. [Method] Reviewed 1680 cases between 1999-2011 who had vertigo as primary symptom, associated with either of 2 or more symptoms as follows：atlanto occipital region pain, nausea（or vomit）, tinnitus（or ear stuffiness）, blurred vision（or rotation）. All the cases had TCD examination which showed over fast or too slow blood flow speed, and 3D-CTA examination（Three-Dimensional Computed Tomography Angiography）. The pathomorp-hological change of the cervical transverse foramen segment of vertebral artery was observed through 3D-CTA technology. [Results]There are 5 kinds of pathomorphological changes in the cervical transverse foramen segment of vertebral artery. They are tenuous vertebral artery, vertebral artery congenital absence, compressed vertebral artery, stretched vertebral artery by fiber bundle, malformation of double vertebral artery. [Conclusion]There are 5 kinds of pathomorphological changes in the cervical transverse foramen segment of vertebral artery related with cervical vertigo.

关 键 词：眩晕 颈性 缺血性 3D-CTA 椎动脉 孔内段 血管形态学 病理改变 

分 类 号：R543[医药卫生—心血管疾病]