血管超声与CT血管造影在眩晕病因诊断中的意义  

Clinical significance of transcranial doppler and computer tomography angiography in etiological diagnosis of dizziness and vertigo

作　　者：程景丽[1] 乌日乐[2] 张玲[1] 史树海[1] Cheng Jingli;Wu Rile;Zhang Ling;Shi Shuhai(Department of Neurosurgery,The First Affiliated Hospital of Baotou Medical College,Baotou 014010,China)

机构地区：[1]包头医学院第一附属医院神经外科,014010 [2]包头医学院第一附属医院血管超声室,014010

出　　处：《北京医学》2018年第8期775-777,共3页Beijing Medical Journal

摘　　要：目的分析血管超声与CT血管造影在头晕、眩晕患者病因诊断中的作用。方法对2017年1～12月在包头医学院第一附属医院神经内科住院的168例头晕患者和92例眩晕患者的临床特征及病因进行分析,所有患者行经颅多普勒超声(transcranial doppler, TCD)、颈部血管彩超,后循环缺血患者加行CT血管造影(CT angiography,CTA)检查。结果头晕组和眩晕组伴高血压病的患者比例差异有统计学意义(58.3%vs. 17.4%, P <0.05),但伴其他脑血管病危险因素的患者比例在2组间差异无统计学意义。头晕和眩晕患者所患前3位疾病分别是后循环缺血(60例, 23.1%)、良性阵发性位置性眩晕(50例,19.2%)和梅尼埃病(37例,14.2%)。后循环缺血患者的椎基底动脉狭窄率显著高于其他头晕或眩晕患者,头颈部CTA显示其血管狭窄阳性率(75.0%)明显高于TCD(65.0%)或颈部血管彩超(61.7%)(P <0.05)。结论临床表现为头晕、眩晕患者最常见的病因是后循环缺血、良性阵发性位置性眩晕和梅尼埃病,血管超声与CT血管造影在眩晕、头晕鉴别诊断中有较好临床应用价值。Objective To analyze the role of vascular ultrasound and computer tomography angiography in the eti- ology diagnosis of patients with dizziness and vertigo. Methods A total of 260 patients including 162 with dizziness and 98 with vertigo admitted in The First Affiliated Hospital of Baotou Medical College from January to December 2017 was analyzed for their clinical features and etiology. All patients underwent transcranial doppler and neck vascular color dop- pler ultrasound. Patients with posterior circulation ischemia received additional head and neck computer tomography angi- ography. Results There was significant difference in the percent of patients with history of hypertension between dizzi- ness and vertigo groups （58.3% vs. 17.4%, P 〈 0.05）, but no significant difference in other risk factors for cerebrovascular diseases among two groups. Posterior circulation ischemia, benign paroxysmal positional vertigo and Meniere＇s disease were the first three common causes of dizziness or vertigo, respectively accounting for 23.1% （60 cases）, 19.2% （50 cases） and 14.2% （37 cases） of all cases. The rate of vertebrobasilar stenosis in patients with posterior circulation ischemia was significantly higher than that in other diseases with dizziness or vertigo, and a higher positive rate of vertebrobasilar steno- sis was showed by CTA （75.0%） when compared with TCD （65.0%） or neck color ultrasound （61.6%）, with significant dif- ferences （P 〈 0.05）, in patients with posterior circulation ischemia. Conclusion It suggests the common causes of dizzi- ness and dizziness are posterior circulation ischemia, benign positional vertigo and Meniere＇s disease. Vascular ultrasound and CT angiography have good clinical value in differential diagnosis of vertigo and dizziness.

关 键 词：头晕 眩晕 经颅多普勒超声 CT血管造影 血管狭窄 

分 类 号：R741[医药卫生—神经病学与精神病学]