颈性眩晕患者经颅多普勒血流参数变化情况及与眩晕程度的关系

Changes of Transcranial Doppler Blood Flow Parameters in Patients with Cervical Vertigo and Their Relationship with the Degree of Vertigo

目的分析颈性眩晕患者的经颅多普勒(TCD)血流参数变化情况,并探讨其与眩晕程度的关系.方法选取本院2020年1月—2021年12月收治的颈性眩晕患者68例为研究对象,将其纳入眩晕组,选取同期健康者21例纳入健康组,对所选对象进行TCD检测,包括椎动脉和基底动脉的收缩期血流速度(V_(S))、平均血流速度(V_(M))、舒张期血流速度(V_(D))、搏动指数(PI)及阻力指数(RI),并对两组血流参数进行比较;同时,根据眩晕障碍量表(DHI)的评分结果,将眩晕组分为三个亚组,即轻度眩晕组(DHI为0~30分,24例)、中度眩晕组(DHI为31~60分,21例)、重度眩晕组(DHI为61~100分,23例),对比三个亚组的TCD血流参数,分析其与DHI评分间的关系.结果眩晕组椎动脉及基底动脉的V_(S)、V_(M)、V_(D)均快于健康组,椎动脉PI、RI均低于健康组,组间差异有统计学意义(P<0.05);眩晕组基底动脉的PI、RI虽低于健康组,但组间差异无统计学意义(P>0.05).重度眩晕组椎动脉、基底动脉的V_(S)、V_(M)、V_(D)均快于轻、中度眩晕组,且中度眩晕组均快于轻度眩晕组,组间差异有统计学意义(P<0.05);三组椎动脉、基底动脉的PI、RI比较,组间差异无统计学意义(P>0.05).眩晕组椎动脉、基底动脉的V_(S)、V_(M)、V_(D)与DHI评分呈正相关(P<0.05).结论颈性眩晕患者TCD的血流速度增快,PI、RI降低,且病情越重指标变化越显著,这可能与血管痉挛或狭窄程度、血管顺应性或韧性的改变等有关,临床诊治中需加以辨别.

Objective To analyze the changes of transcranial Doppler(TCD)blood flow parameters in patients with cervical vertigo,and to explore their correlation with the degree of vertigo.Methods A total of 68 patients with cervical vertigo admitted to the hospital from January 2020 to December 2021 were selected as the research objects and were included into the vertigo group,and 21 healthy patients which were selected in the same period were included into the healthy group.TCD detection was performed on the selected subjects,the systolic blood flow velocity(V_(S)),mean blood flow velocity(V_(M)),diastolic blood flow velocity(V_(D)),pulsatile index(PI)and resistance index(RI)of vertebral artery and basilar artery were compared.Meanwhile,according to the score of dizziness handicap inventory(DHI),the patients in vertigo group were divided into a mild vertigo group(DHI 0~30 points,24 cases),a moderate vertigo group(DHI 31~60 points,21 cases),and a severe vertigo group(DHI 61~100 points,23 cases),the blood flow parameters of TCD in the three subgroups were compared and the relationship between them and DHI score was analyzed.Results V_(S),V_(M)and V_(D)of vertebral artery and basilar artery in vertigo group were faster than those in healthy group,PI and RI of vertebral artery were lower than those in healthy group,the differences between the groups were statistically significant(P<0.05);the PI and RI of basilar artery in vertigo group were lower than those in healthy group,but there were no significant differences between groups(P>0.05).The V_(S),V_(M)and V_(D)of vertebral artery and basilar artery in severe vertigo group were faster than those in mild and moderate vertigo group,and the moderate vertigo group were faster than the mild vertigo group,the differences between the groups were statistically significant(P<0.05);there were no significant differences in PI and RI of vertebral artery and basilar artery among the three groups(P>0.05).In the vertigo group,there was a positive correlation between V_(S),V_(M)and V_(D)of vertebral artery and basilar artery and DHI score(P<0.05).Conclusion In patients with cervical vertigo,the blood flow velocity of TCD increases,and the PI and RI decrease,and the more severe the disease,the more significant the change of indicators,which may be related to the degree of vasospasm or stenosis,the change of vascular compliance or toughness,and so on,need to be identified in clinical diagnosis and treatment.