转颈试验对单侧椎动脉走行变异患者椎动脉血流动力学影响的超声评估  

Ultrasonographic evaluation of the influence of the rotating neck test on the hemodynamics of vertebral arteries in patients with vertebral artery course variation

作　　者：付静静 勇强[1] 张蕾[1] 王立娟[1] 李亮[1] 王明月[1] 魏芸[1] 濮恬宁 朱玉萍[1] FU Jingjing;YONG Qiang;ZHANG Lei;WANG Lijuan;LI Liang;WANG Mingyue;WEI Yun;PU Tianning;ZHU Yuping(Department of Ultrasound,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所综合超声科,100029

出　　处：《心肺血管病杂志》2020年第11期1376-1379,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:探讨转颈试验对单侧椎动脉走行变异患者椎动脉血流动力学的影响及其与颈性眩晕的关系。方法:2017年8月至2020年1月,选取单侧椎动脉走行变异的患者116例为研究对象。采用自身对照研究方法,对比转颈试验前及转颈试验后的血流动力学参数,主要包括收缩期峰值流速(PSV)、舒张末期流速(EDV)、阻力指数(RI),并分析参数的变化与颈性眩晕的关系。116例椎动脉走行变异的椎动脉按照内径大小分发育不良组及内径正常组,并比较转颈试验前后参数的变化。结果:转颈试验后,椎动脉RI较转颈试验前明显增大,差异有统计学意义(P<0.001),且眩晕的发生率明显增加(75.0%vs.55.2%)。PSV的平均值转颈试验后比转颈试验前增大,但差异无统计学意义(P>0.05)。按照椎动脉内径分组结果显示:转颈试验前,椎动脉发育不良组RI平均值明显高于内径正常组(P<0.05)。转颈试验后结果显示,椎动脉发育不良组RI值高于内径正常组(P<0.05)。转颈试验前后椎动脉发育不良组与内径正常组相比,PSV(cm/s)平均值有所提高,但均差异无统计学意义(P>0.05)。转颈试验后,两组眩晕的发生率均增加,特别是内径正常组增加的更明显(71.9%vs.50.5%)。结论:单侧椎动脉走行变异患者,转颈试验有助于颈性眩晕的诊断,可作为颈性眩晕诊断的一个客观指标。Objective:To explore the effect of the neck rotation test on the vertebral artery hemodynamics in patients with vertebral artery course variation and the relationship with cervical vertigo.Methods:A total of 116 patients with vertebral artery course variation during August 2017 to January 2020 were selected as the study subjects.Self-control method was used,comparing the hemodynamic parameters before and after neck rotation test,mainly including peak systolic flow velocity(PSV),end diastolic velocity(EDV)and resistance index(RI),and analyze the relationship between the change of parameters and cervical vertigo.According to the inner diameter of the vertebral artery,it was divided into dysplasia group and normal diameter group,and the changes of parameters before and after turning neck were compared.Results:Vertebral artery RI was significantly increased compared with that before turning neck,and the difference was statistically significant(P<0.001).The incidence of cervical vertigo was significantly increased after turning neck and before turning neck(75.0%vs.55.2%).The average value of PSV increased after turning neck than before turning neck,but the difference was not statistically significant(P>0.05).The result of grouping according to the inner diameter of the vertebral artery showed that before the neck test,the average RI of the dysplastic vertebral artery group was significantly higher than that of the normal diameter group(P<0.05).The result after turning neck test showed that the RI values of the vertebral artery dysplasia group and the normal diameter group were significantly increased(P<0.05).The average value of PSV(cm/s)has increased,but the differences are not statistically significant(P>0.05).Moreover,after the neck-turning experiment,the incidence of vertigo in both groups increased significantly (71.9%vs.50.5%).Conclusions:Patients with vertebral artery course variation,The turning-neck tests is helpful for the diagnosis of the cervical vertigo and will be one of objective indictors of the diagno

关 键 词：椎动脉 转颈试验 椎动脉走行变异 颈性眩晕 

分 类 号：R54[医药卫生—心血管疾病]