锁骨下动脉盗血综合征的临床表现与逆流超声分型的相关性  

Clinical manifestations and correlation with retrograde ultrasound classification in subclavian steal syndrome

作　　者：张利媛[1] 张慧[1] 运宏飞 李智慧[1] 陶书英 柏艳芳 李莹[1] Zhang Liyuan;Zhang Hui;Yun Hongfei;Li Zhihui;Tao Shuying;Bai Yanfang;Li Ying(Tianjin Hospital of Occupational Disease Prevention,Tianjin 300011,China)

机构地区：[1]天津市职业病防治院,天津300011

出　　处：《首都食品与医药》2024年第21期103-106,共4页Capital Food Medicine

摘　　要：目的探讨锁骨下动脉盗血综合征(subclavian steal syndrome,SSS)的临床表现与逆流超声分型的相关性。方法选择2020年6月-2024年4月在本院诊治的锁骨下动脉盗血综合征患者68例作为研究对象,所有患者都给予彩色多普勒超声检查或者彩色多普勒超声与经颅多普勒超声联合检查,记录超声特征。同时调查所有患者的临床表现并进行相关性分析。结果在68例患者中,临床表现为眩晕38例、感觉异常5例,双侧视力障碍7例、间歇性跛行10例、发音困难5例、耳鸣9例、抽搐2例。锁骨下动脉逆流超声分型判断为盗血Ⅰ期29例,盗血Ⅱ期30例,盗血Ⅲ期9例。彩色多普勒超声判断为锁骨下动脉轻度狭窄34例,中度狭窄28例,重度狭窄5例,闭塞1例。随着逆流超声分型的增加与狭窄程度的增加,椎动脉收缩期峰值流速患侧流速都显著上升(P<0.05)。在68例患者中,盗血Ⅰ期临床主要表现为眩晕、感觉异常,盗血Ⅱ期临床主要表现为眩晕、双侧视力障碍、间歇性跛行,盗血Ⅲ期临床主要表现为耳鸣、抽搐。结论彩色多普勒超声与经颅多普勒超声检查能较全面地评估锁骨下动脉盗血综合征的患者血流动力学变化,锁骨下动脉盗血综合征的临床表现与逆流超声分型存在相关性。Objective To explore and analyze the correlation between the clinical manifestations and the retrograde ultrasound classification of subclavian steal syndrome(SSS).Methods A total of 68 patients from June 2020 to April 2024 with subclavian artery steal syndrome were selected as study subjects.All patients were given color Doppler ultrasound or combined color Doppler ultrasound and transcranial Doppler ultrasound to record ultrasound features.The clinical manifestations of all patients were also investigated and correlation analysis.Results Of the 68 patients,the clinical manifestations were 38 vertigo,5 paresthesia,7 bilateral visual impairment,10 intermittent claudication,5 dysphonia,9 tinnitus,and 2 convulsions.29 cases had stage I,30 cases stageⅡand 9 cases stageⅢ.Color Doppler ultrasound judged 34 mild stenosis,28 moderate stenosis,5 severe stenosis and 1 occlusion.With the increase in the retrograde ultrasound classification and the degree of stenosis,the peak systolic velocity of the vertebral artery on the affected side significantly increased(P<0.05).Among the 68 patients,the clinical manifestations of stage I blood theft mainly include dizziness and sensory abnormalities,stage II blood theft mainly includes dizziness,bilateral visual impairment,and intermittent claudication,and stage III blood theft mainly includes tinnitus and convulsions.Conclusion Color Doppler ultrasound and transcranial Doppler ultrasound examination can comprehensively evaluate the hemodynamic changes in patients with subclavian artery steal syndrome,and the clinical manifestations of the syndrome and countercurrent ultrasound classification are correlated.

关 键 词：锁骨下动脉盗血综合征 临床表现 逆流超声分型 彩色多普勒超声 经颅多普勒超声 

分 类 号：R445.1[医药卫生—影像医学与核医学]