血管超声检查对锁骨下动脉狭窄合并椎动脉狭窄的诊断价值  

Value of vascular ultrasound examination in the diagnosis of subclavian artery stenosis combined with vertebral artery stenosis

作　　者：周琼怀 Qionghuai Zhou(Department of Ultrasound,Zhuji People's Hospital,Zhuji 311800,Zhejiang Province,China)

机构地区：[1]诸暨市人民医院超声科,诸暨311800

出　　处：《中国基层医药》2023年第10期1441-1445,共5页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省医药卫生科技计划(2019KY731)。

摘　　要：目的观察血管超声检查用于诊断锁骨下动脉狭窄(ASA)合并椎动脉狭窄(VSA)及盗血类型的效果。方法选取诸暨市人民医院2018年2月至2022年5月收治的ASA合并VSA患者70例为研究对象,患者均进行数字减影血管成像(DSA)及血管超声检查。以DSA检查结果为参照标准,评价血管超声对ASA和VSA程度分型诊断准确度及与DSA检查诊断结果的一致性,比较DSA检查与血管超声检查对锁骨下动脉盗血检出率的差异,分析ASA程度与锁骨下动脉盗血严重程度的相关性。结果血管超声检查对不同程度ASA的诊断准确性分别为84.62%(11/13)、89.66%(26/29)、95.24%(20/21)、100.00%(7/7),血管超声检查与DSA对ASA的诊断结果一致性Kappa值为0.876(P<0.05);血管超声检查对VSA的诊断准确性分别为94.44%(17/18)、88.00%(22/25)、86.36%(19/22)、100.00%(5/5),血管超声检查与DSA对VSA的诊断结果一致性Kappa值为0.858(P<0.05);不同ASA程度患者锁骨下动脉盗血类型差异有统计学意义(χ^(2)=50.71,P<0.001);锁骨下动脉盗血程度与ASA程度呈高度正相关(r=0.71,P<0.001)。结论血管超声检查对不同严重程度的ASA和VSA均具有较高的诊断准确性,与DSA诊断结果一致性较高,且可提高锁骨下动脉盗血检出率,在ASA、VSA及锁骨下动脉盗血的早期筛查和病情监测方面有一定优势。Objective To investigate the effectiveness of vascular ultrasound examination in the diagnosis of subclavian artery stenosis(ASA)combined with vertebral artery stenosis(VSA)and its effects on different types of steal syndrome.Methods Seventy patients with ASA combined with VSA who received treatment in Zhuji People's Hospital from February 2018 to May 2022 were included in this study.All patients underwent digital subtraction angiography(DSA)and a vascular ultrasound examination.Taking the DSA examination results as the reference standard,the accuracy of vascular ultrasound examination in the classification of ASA and VSA and its consistency with the DSA diagnosis results were evaluated.The detection rate of subclavian artery steal was compared between DSA and vascular ultrasound examination was compared.The correlation between the degree of ASA and the severity of subclavian artery steal was analyzed.Results The accuracy of vascular ultrasound examination in the diagnosis of different degrees of ASA was 84.62%(11/13),89.66%(26/29),95.24%(20/21),and 100.00%(7/7),respectively.The Kappa value,indicating the consistency of vascular ultrasound examination and DSA restults in the diagnosis of ASA,was 0.858(P<0.05).There was a significant difference in the type of subclavian artery steal among patients with different degrees of ASA(χ^(2)=50.71,P<0.01).The severity of subclavian artery steal was highly positively correlated with the severity of ASA(r=0.71,P<0.001).Conclusion Vascular ultrasound examination has high diagnostic accuracy for different degrees of ASA and VSA,has high consistency with DSA results,and can increase the detection rate of subclavian artery steal.Vascular ultrasound examination has certain advantages in the early screening and condition monitoring of ASA,VSA,and subclavian artery steal.

关 键 词：超声检查 多普勒 彩色 超声检查 介入性 锁骨下动脉窃血综合征 椎底动脉供血不足 血管造影术 数字减影 诊断 对比研究 

分 类 号：R445.1[医药卫生—影像医学与核医学] R743[医药卫生—诊断学]