右锁骨下动脉起始段>50%狭窄的超声评价法  

Evaluation of > 50% stenosis of the right subclavian artery starting segment by ultrasound measurement technique

作　　者：林友国[1] 杨焱 陈梅青 LIN Youguo;YANG Yan;CHEN Meiqing(Division of Ultrasound Diagnosis in Preventive Treatment of Disease in Traditional Chi-nese Medicine,the Affiliated People＇s Hospital of Fujian University of Traditional Chinese Medicine,Fuzhou,350004,China)

机构地区：[1]福建中医药大学附属人民医院治未病科超声诊断室,福建福州350004

出　　处：《中国中西医结合影像学杂志》2018年第6期604-606,共3页Chinese Imaging Journal of Integrated Traditional and Western Medicine

基　　金：福建省教育厅中青年教师教育科研项目(JAT170277)

摘　　要：目的:应用超声测量技术评价右锁骨下动脉起始段> 50%的狭窄。方法:入组76例(观察组46例,对照组30例),均无明显椎动脉盗血综合征。观察组右锁骨下动脉起始段直径狭窄率50%～60%,对照组<50%。超声测量右锁骨下动脉起始段狭窄处的峰值流速(PSV)和直径狭窄率,并比较2组PSV。以双侧上肢血压差值> 20 mmHg(1 mm Hg=0.133 kPa)为金标准,ROC曲线综合评价PSV与直径狭窄率的诊断准确度。结果:观察组PSV明显增加,与对照组比较差异有统计学意义(P<0.05)。直径狭窄率和PSV对判断双上肢血压差值> 20 mmHg均有一定价值,且两者诊断准确度差异无统计学意义(P> 0.05)。结论:超声通过测量右锁骨下动脉起始段狭窄处PSV和直径狭窄率可判断右锁骨下动脉起始段> 50%的狭窄,推荐PSV作为主要的超声评价法,并以115 m/s作为PSV的判断界点。Objective：To evaluate 〉50% stenosis of the right subclavian artery starting segment by ultrasound measurement technique. Methods：76 subjects were enrolled （46 in the observation group and 30 in the control group）. None of them had vertebral arterial steal syndrome. Diameter stenosis rate of the right subclavian artery starting segment was 50%--60%. Ultra- sound measured the peak flow velocity and diameter stenosis rate of the right subclavian artery starting segment,the peak flow velocity of which was compared between two groups. The blood pressure difference between the upper limbs 〉20 mmHg was used as the gold standard. The diagnostic accuracy of peak flow rate and diameter stenosis rate was evaluated comprehensively by ROC and the difference between peak flow rate and diameter stenosis rate was compared. Results：The peak flow velocity in the control group increased significantly. The difference was statistically significant （P〈0.05）. Both of diameter stermsis rate and peak flow rate had a certain value for judging the difference between the two upper limb blood pressure 〉20 mmHg and there was no significant difference in the diagnostic accuracy of them （P〉0.05）. Conclusion：Ultrasound can be used to determine the stenosis of the right subclavian artery initial segment 〉50% by measuring the peak flow velocity and the stenosis rate of the right subclavian artery at the beginning of the stenosis. Peak flow rate is recommended as the main ultrasound evaluation method and 115 cm/s is used as the judgment point of peak flow velocity.

关 键 词：右锁骨下动脉起始段 峰值流速 直径狭窄率 

分 类 号：R445.1[医药卫生—影像医学与核医学] R543.5[医药卫生—诊断学]