CT血管造影和经颅多普勒超声检查在锁骨下动脉狭窄中的应用价值  

Application Value of CT Angiography and Transcranial Doppler Sonography in Subclavian Artery Stenosis

作　　者：蓝玉[1] 周少旦 韦馨娴 李宁[1] 钟良 韦英海[1] LAN Yu;ZHOU Shaodan;WEI Xinxian;LI Ning;ZHONG Liang;WEI Yinghai(Department of Neurology,Ethnic Hospital Affiliated to Guangxi Medical University(Ethnic Hospital of Guangxi Zhuangzu Autonomous Region),Nanning 530001,China)

机构地区：[1]广西医科大学附属民族医院(广西壮族自治区民族医院)神经内科

出　　处：《实用心脑肺血管病杂志》2019年第10期69-72,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：广西壮族自治区卫生和计划生育委员会科研课题(Z20170288)

摘　　要：目的分析CT血管造影(CTA)和经颅多普勒超声(TCD)检查在锁骨下动脉狭窄中的应用价值。方法选取广西壮族自治区民族医院神经内科2016年1月-2019年3月收治的锁骨下动脉狭窄患者53例,均经CTA、TCD检查证实。回顾性分析所有患者CTA、TCD检查结果,锁骨下动脉狭窄程度与盗血程度的相关性分析采用Spearman秩相关分析;根据CTA检查结果将39例中度及以上锁骨下动脉狭窄患者分为A组23例(单侧锁骨下动脉狭窄且未合并其他动脉狭窄或闭塞)和B组16例(合并颈总动脉、颈内动脉或椎动脉中度以上狭窄或闭塞),比较两组患者盗血发生率、束臂试验阳性率。结果(1)CTA检查结果:锁骨下动脉狭窄部位:左侧36例,右侧17例;锁骨下动脉狭窄程度:轻度14例,中度12例,重度15例,闭塞12例;锁骨下动脉狭窄原因:动脉粥样硬化斑块50例,多发性动脉炎3例。(2)TCD检查结果:无盗血18例,Ⅰ期盗血12例,Ⅱ期盗血10例,Ⅲ期盗血13例。(3)Spearman秩相关分析结果显示,锁骨下动脉狭窄程度与盗血程度呈正相关(rs=0.779,P<0.01)。(4)B组患者盗血发生率、束臂试验阳性率低于A组(P<0.05)。结论CTA和TCD检查在锁骨下动脉狭窄中的应用价值均较高,且锁骨下动脉狭窄程度与盗血程度呈正相关,临床发现疑诊锁骨下动脉狭窄患者但TCD检查结果存在不符合特定规律的血流频谱时,应结合CTA检查进一步观察锁骨下动脉狭窄程度及头颈部其他动脉病变情况。Objective To analyze the application value of CT angiography(CTA)and transcranial Doppler sonography(TCD)in subclavian artery stenosis.Methods From January 2016 to March 2019,a total of 53 patients with subclavian artery stenosis were selected in the Department of Neurology,Ethnic Hospital of Guangxi Zhuangzu Autonomous Region,who were confirmed by CTA and TCD.CTA and TCD examination results of all of the 53 patients were retrospectively analyzed,correlation between degree of subclavian artery stenosis and degree of subclavian steal was analyzed by Spearman rank correlation analysis;39 patients with medium or above stenosis were divided into A group(with unilateral subclavian artery stenosis and did not merge with stenosis/occlusion of other arteries,n=23)and B group(merged with medium or above stenosis/occlusion of common carotid artery,internal carotid artery or vertebral artery,n=16)according to the CTA examination results,after that incidence of subclavian steal and positive rate of tourniquet test were compared between the two groups.Results(1)CTA examination results:locations of subclavian artery stenosis:36 cases in the left and 17 cases in the right;degree of subclavian artery stenosis:14 cases with mild,12 cases with medium,15 cases with severe and 12 cases with occlusion;causes of subclavian artery stenosis:50 cases caused by atherosclerotic plaques and 3 cases caused by multiple arteritis.(2)TCD examination results found 18 cases without subclavian steal,12 cases withⅠ-stage subclavian steal,10 cases withⅡ-stage subclavian steal and 13 cases withⅢ-stage subclavian steal.(3)Spearman rank correlation analysis results showed that,degree of subclavian artery stenosis was positively correlated with the degree of subclavian steal(rs=0.779,P<0.001).(4)Incidence of subclavian steal and positive rate of tourniquet test in B group were statistically significantly lower than those in A group(P<0.05).Conclusion CTA and TCD have relatively high application value in subclavian artery stenosis,and degree of sub

关 键 词：锁骨下动脉狭窄 CT血管造影 经颅多普勒超声 

分 类 号：R743.31[医药卫生—神经病学与精神病学]