颈椎病血流动力学与临床意义探讨

The study of cervical syndrome's hemodynamics and clinical significance

目的探讨颈椎病血流动力学变化及临床意义。方法应用经颅多谱勒超声(TCD)测定颈椎病患者双侧椎动脉及基底动脉血流Vm、Vs、Vd及频谱形态、脉动指数、阻力指数,并结合影像学改变, 了解颈椎病血流动力学对颅内供血的影响。结果 327例临床诊断颈椎病,TCD测定血流动力学异常 272例(83．18％),正常55例(16．82％),其中椎动脉型颈椎病261例,TCD异常242例(78.54％);交感型颈椎病7例,TCD异常6例(85．71％);神经根型颈椎病9例,TCD异常6例(66．67％);脊髓型颈椎病21 例,TCD异常1例(4．76％);混合型颈椎病29例,TCD异常17例(58．62％)。频谱形态、脉动指数、阻力指数等参数随年龄的增长而改变,无统计学意义。结论颈椎病患者基底动脉及双侧椎动脉血流减慢对临床颈椎病诊断具有较高敏感性和特异性,对临床诊断有重要的参考价值。

Objective To investigate the changes of hemodynamics and its clinical significance in cervical syndrome. Methods Vm and Vs of vertebral artery（VA ） and basilar artery（BA） were measured by transcranial Doppler ultrasound（TCD） in the patients of the cervical syndrome, so did spectral situation, PI and RI conbining the change of imaging study to comprehend effect on supports to the blood of the cranium in cervical syndrome＇s. Results 327 cases of cervical syndrome finally were measured by TCD among them of normal 55（16.82%）and of unusual 272（83. 18%）. In 261 case of vertebral artery type of cervical spondylosis, there were 242（78. 54%）unusual case. In 7 case of sympathetic cervical spondylosis, there were 6 （85. 71%）unusual case- In 9 case of cervicalspondylotic radiculopathy, there were 6（66. 67%0）unusual case. In 21 case of cervical spondylotic myelopathy, there was 1（4.76%）unusual case- In 29 case of mixed type of cervical syndrome, there were 17（58. 62%）unusual case. Parametes, such as spectral situation,PI Vm,Vd , changing with growth of the age, this group does not have statistics meaning. Conclusions The changes of BA and VA hemodynamics in cervical syndrome patiens have hypersensitivity and hyperspecificity, there is greater reference value to the cervical syndrome of clinical diagnosi.