头晕患者孤立性椎动脉颅内段血流速度减低分析  

Analysis of reduced flow velocity of isolated vertebral artery at intracranial segments in patients with dizziness

作　　者：李兆妍 张晓曼[2] 朱亚涛 王军杰[3] 吕爱红[3] 曹心慧[2] LI Zhao-yan;ZHANG Xiao-man;ZHU Ya-tao;WANG Jun-jie;LüAi-hong;CAO Xin-hui(Department of Neurologey,The First Affiliated Hospital of Henan University of CM,Zhengzhou 450099,Henan,China;Department of Neurology,the Zhengzhou First People’s Hospital,Zhengzhou 451475,Henan,China;Department of Ultrasound,the Zhengzhou First People’s Hospital,Zhengzhou 451475,Henan,China)

机构地区：[1]河南省中医药大学第一附属医院脑病科,河南郑州450099 [2]郑州市第一人民医院神经内科,河南郑州451475 [3]郑州市第一人民医院超声科,河南郑州451475

出　　处：《生物医学工程与临床》2022年第4期427-430,共4页Biomedical Engineering and Clinical Medicine

基　　金：河南省自然科学基金资助项目(162300410045)。

摘　　要：目的 分析头晕患者椎动脉血流动力学,探讨孤立性单侧椎动脉颅内段血流速度减低的原因。方法 选择以头晕为主诉且单侧椎动脉血流速度<40 cm/s的患者29例,其中男性21例,女性8例;年龄34~85岁,平均年龄61.52岁。运用颈部血管超声仪测量椎动脉椎间隙段血管管径,收缩期峰值血流速度(Vp)、阻力指数(RI);运用经颅多普勒仪(TCD)测量椎动脉颅内段Vp、平均血流速度(Vm)、舒张期末血流速度(EDV)、血管搏动指数(PI)。比较患侧与健侧椎动脉Vp、Vm、EDV、PI,比较患侧与健侧椎动脉椎间隙段的血管管径、Vp、RI,比较患侧椎动脉颅内段与椎间隙段的Vp。结果 患侧椎动脉Vp、Vm、EDV较健侧减低,差异有统计学意义[(30.59±4.32) cm/s vs (51.28±11.37) cm/s、(17.86±2.89) cm/s vs (29.67±6.31) cm/s、(11.55±2.44) cm/s vs (19.38±4.23) cm/s。P <0.05];而PI无明显变化,差异无统计学意义(P> 0.05)。患侧椎动脉椎间隙段血管管径较健侧细,差异有统计学意义[(3.17±0.50) mm vs (3.48±0.53) mm。P <0.05];而两侧Vp、RI无明显变化,差异无统计学意义(P> 0.05)。患侧椎动脉颅内段Vp较椎间隙段减低,差异有统计学意义[(30.59±4.32) cm/s vs (40.97±8.83) cm/s。P <0.05]。结论 孤立性单侧椎动脉血流速度减低而PI正常的头晕患者,存在椎间隙段管径纤细。椎动脉管径纤细可能仅引起颅内段血流速度减低,而椎间隙段血流速度正常。TCD对头晕患者颅内外筛查有利于椎动脉病变的诊断。Objective To analyze hemodynamics of vertebral artery in patients with dizziness, and explore the causes of reduced flow velocity at intracranial segments of isolated unilateral vertebral artery. Method A total of 29 patients with dizziness and unilateral vertebral artery blood flow velocity < 40 cm/s were enrolled, which included 21 males and 8 females, aged 34-85 years old with mean age of 61.52 years old. The vascular diameter, peak systolic velocity(Vp) and resistance index(RI)of vertebral artery and intervertebral segments were measured by cervical vascular ultrasound. The transcranial Doppler(TCD) was used to measure Vp, mean blood velocity(Vm), end-diastolic blood velocity(EDV) and vascular pulsatility index(PI) of intracranial vertebral artery. Bilateral vertebral artery Vp, Vm, EDV, PI and vertebral artery diameter, Vp, RI between affected side and healthy side, and affected side Vp between intracranial and intervertebral segments of vertebral artery were compared. Results Vp, Vm and EDV of vertebral artery on affected side were lower than those on healthy side,and the difference was statistically significant[(30.59 ± 4.32) cm/s vs(51.28 ± 11.37) cm/s,(17.86 ± 2.89) cm/s vs(29.67 ± 6.31) cm/s,(11.55 ± 2.44) cm/s vs(19.38 ± 4.23) cm/s. P < 0.05], while there was no significant change in PI, and the difference was not statistically significant(P > 0.05). The intervertebral vessel diameter of vertebral artery on affected side was thinner than that on healthy side, and the difference was statistically significant[(3.17 ± 0.50) mm vs(3.48 ± 0.53) mm. P < 0.05]. There was no significant change in bilateral Vp and RI, and difference was not statistically significant(P > 0.05). The Vp of intracranial segment on affected vertebral artery was lower than that of intervertebral segment, and the difference was statistically significant[(30.59 ± 4.32) cm/s vs(40.97 ± 8.83) cm/s. P < 0.05]. Conclusion It is demonstrated that in patients with isolated unilateral vertebral artery with reduced blood flow velocit

关 键 词：头晕 椎动脉 血管管径 血流速度 椎动脉发育不良 

分 类 号：R741[医药卫生—神经病学与精神病学] R445.1[医药卫生—临床医学]