经颅多普勒对椎-基底动脉延长扩张症患者椎-基底动脉血流动力学的分型分析  

Typing Analysis of Hemodynamics in Vertebrobasilar Artery in Patients with Vertebrobasilar Dolichoectasia by Transcranial Doppler

作　　者：魏佳军[1] 曾非[1] 毛善平[1] 张兆辉[1] 曾庆杏[1] WEI Jia-j un ZENG Fei MAO Shan-ping ZHANG Zhao-hui ZENG Qing-xing(Department of Neurology, Renmin Hospital of Wuhan University, Wuhan 430060, Chin)

机构地区：[1]武汉大学人民医院神经内一科,武汉430060

出　　处：《微循环学杂志》2017年第3期56-61,共6页Chinese Journal of Microcirculation

摘　　要：目的:分析椎-基底动脉延长扩张症(VBD)患者椎-基底动脉的血流动力学特点。方法:应用经颅多普勒(TCD)检查47例VBD患者(VBD组)椎-基底动脉血流动力学指标,包括收缩期峰流速度(Vs)、舒张末期峰流速度(Vd)、平均血流速度(Vm)和搏动指数(PI),并根据PI值将VBD组患者分成3个亚组:高阻力型组(n=20)、正阻力型组(n=12)和低阻力型组(n=15)。分析各亚组基础疾病、大脑后动脉狭窄/扩张及后循环梗死发生率的差异。选择有头晕呕吐、行走不稳等椎-基底动脉系统症状但行头颈CT血管造影检查椎-基底动脉无异常的同期住院患者作为对照组(n=21)。结果:VBD患者椎-基底动脉Vs、Vd、Vm较对照组下降(P<0.01)。VBD三亚组间椎-基底动脉延长分呈高阻力型组>正阻力型组>低阻力型组,扩张分呈低阻力型组>正阻力型组>高阻力型组(均P<0.01),高阻力型组高血压病及高脂血症发生率高于正阻力型组及低阻力型组(P<0.05或P<0.01),而低阻力型组高血压病及高脂血症的发生率低于正阻力型组(P<0.05)。各亚组间糖尿病和高同型半胱氨酸(HCY)血症发生率差异无统计学意义(P>0.05)。高阻力型组大脑后动脉狭窄及后循环梗死的发生率显著高于正阻力型组及低阻力型组(P<0.05)。低阻力型组大脑后动脉扩张的发生率高于正阻力型(P<0.05),而其后循环梗死的发生率显著低于正阻力型(P<0.05)。结论:VBD存在后循环血流动力学障碍,对其血流动力学进行分型分析有助于理解后循环梗死的发病机制及指导临床治疗实践。Objective：To analyze the hemodynamic characteristics of vertebrobasilar artery in patients with vertebrobasilar dolichoectasia（VBD）.Method：The hemodynamic index of vertebrobasilar artery in 47 patients with VBD was examined by transcranial doppler（TCD）,which included systolic peak flow velocity（Vs）,diastolic peak velocity（Vd）,mean flow velocity（Vm）and pulsatility index（PI）.According to PI value,they were divided into 3subgroups：high resistance group（n=20）,normal resistance group（n=12）and low resistance group（n=15）.The difference incidences of underlying diseases,the stenosis/dilatation of posterior cerebral artery and infarction in posterior circulation in all subgroups were analyzed.Patients with symptoms such as vertigo,vomiting and unstable gait in vertebrobasilar system served as controls,whose vertebrobasilar artery was showed no abnormality by head and neck CT angiography（n=21）.Results：Vs,Vd and Vm of vertebrobasilar artery in patients with VBD were lower than those in the controls（P〈0.01）.Among the 3subgroups,the elongation score of vertebrobasilar artery in the high resistance group was higher than that in the normal resistance group,which in the latter was higher than that in the low resistance group（P〈0.05）.The dilatation score of vertebrobasilar artery in the low resistance group was higher than that in the normal resistance group,which in the latter was higher than that in the high resistance group（P〈0.05）.The incidence of hypertension and hyperlipemia in the high resistance group was higher than that in the normal resistance group and in the low resistance group（P〈0.05 or 0.01）,while the incidence of hypertension and hyperlipemia in the low resistance group was lower than that in the normal resistance group（P〈0.05）.There was no significant difference in the incidence of diabetes and hyperhomocysteinemia between groups（P〈0.05）.The incidence of stenosis in posterior cerebral artery and infarction in posterior circulatio

关 键 词：椎-基底动脉延长扩张症 经颅多普勒 血流动力学 

分 类 号：R743.9[医药卫生—神经病学与精神病学]