超声对椎动脉颅外段与颅内段闭塞患者的血流动力学评价  

Hemodynamic evaluation of extracranial and intracranial occlusions of vertebral artery by ultrasound

作　　者：张莹[1] 刘红英[1] 徐洁 刘卫彬[2] 高庆春[1] ZHANG Ying;LIU Hongying;XU Jie;LIU Weibin;GAO Qingchun(Department of Neurology,the 2nd Affiliated Hospital,Guangzhou Medical University,Guangzhou 510260,China)

机构地区：[1]广州医科大学附属第二医院神经内科,广州510260 [2]中山大学附属第一医院神经内科,广州510080

出　　处：《实用医学杂志》2018年第22期3792-3795,共4页The Journal of Practical Medicine

基　　金：广东省公益研究与能力建设专项资金项目(编号:2014A020212328)

摘　　要：目的采用经颅多普勒超声(TCD)及彩色多普勒超声(CDFI)研究伴有椎动脉闭塞的神经科住院患者,探讨其患侧与健侧椎动脉的血流动力学变化规律。方法纳入脑血管造影(DSA)显示单侧椎动脉颅外段闭塞者48例(颅外组)、颅内段闭塞者39例(颅内组),取同年龄组DSA阴性者40例作为正常对照组(正常组)。采用TCD及CDFI检测,记录双侧椎动脉管径、收缩期血流速度(PSV)、血管搏动指数(PI)或血管阻力指数(RI)。结果颅内组、颅外组患侧椎动脉管径、PSV低于健侧,也低于正常组(P <0.05);颅内组患侧椎动脉PI高于健侧、正常组及颅外组(P <0.05),颅外组最低。颅内组、颅外组健侧椎动脉PSV大于正常组(P <0.05),颅外组最高。结论通过CDFI与TCD的联合诊断可以客观评价椎动脉颅外段或颅内段闭塞患者患侧和健侧椎动脉的血流动力学特征性变化,从而快速有效地为临床医生提供诊断证据,避免误诊和漏诊。Objective Using transcranial Doppler ultrasound(TCD)and color Doppler ultrasound(CDFI)to study the vertebral artery with extracranial or intracranial occlusion in neurological inpatients.Methods The patients were hospitalized and the cerebral angiography(DSA)showed 48 cases of unilateral vertebral artery extra-cranial occlusion(extracranial group)and 39 intracranial occlusion(intracranial group),and 40 cases of DSA negative were selected as normal control group(normal group).The diameter,systolic blood flow velocity(PSV),vascular pulsation index(PI)and vascular resistance index(RI)were collected.Results In the intracranial group and the extracranial group,the diameter of the affected side and the PSV were lower than those in the normal group(P<0.05).The PI in the intracranial group was higher than that in the normal group(P<0.05),while PI in the extracranial group was lower than the normal group(P<0.05).In the intracranial group,the diameter and PI of the affected side were higher than that of the extracranial group(P<0.05),when the PSV of them were larger than the normal group(P<0.05).Conclusion The combined diagnosis of CDFI and TCD can timely evaluate the hemodynamic characteristics of the vertebral arteries after occlusion,in order to provide diagnostic evidence for clinicians quickly and effectively.

关 键 词：椎动脉闭塞 血流动力学 经颅多普勒超声 彩色多普勒超声 

分 类 号：R743.3[医药卫生—神经病学与精神病学]