中老年眩晕与椎-基底动脉供血障碍的临床研究

Relationship between the dizziness of middle-aged and old people and blood supply insufficiency of vertebrobasilar artery

目的探讨中老年眩晕与椎-基底动脉供血障碍的关系。方法对经头颅CT、颅多普勒(TCD)、颈椎片、血糖、血脂、血液流变学检查的271例患者的临床资料进行分析。结果271例患者中血糖、血脂、血液流变学不同程度异常,所有患者颈椎片骨质、椎间盘退行性改变。经颅多普勒示血流改变。结论从临床表现、特殊检查资料和神经系统检查将椎-基底动脉供血障碍分为椎-基动脉短暂性缺血发作(VB-TIA)和椎-基底动脉供血不足(VBI)。VB-TIA是指由于椎基底动脉主干、分支的动脉粥样硬化病变,引起相应灌流区缺血,出现复杂多变的并在24h内消失的临床症状。而VBI则是指椎-基底动脉由于各种原因引起的形态、机能异常,产生相应灌流区供血不足状态,并持续存在超过24h的临床症状和体征。由于椎-基底动脉供血障碍易引起脑干、小脑及大脑半球后部等灌流区的机能障碍。并且这些症状的短暂、反复出现多为脑干梗死的前兆。应针对存在的缺血性脑血管病(ICVD)危险因子采取相应的预防保健措施,并进行改善脑循环及去除ICVD危险因子的干预治疗。

Objective To evaluate the relationship between the dizziness of middle -aged and old people and blood supply insufficiency of vertebrobasilar artery. Methods Clinical data of 271 patients who accepted the examination of brain CT, transcranial Doppler, cervical vertebra film, blood sugar and lipid and hemorheology were analyzed. Results There were abnormality more or less in blood sugar, blood lipid and hemorheology, degeneration of bone substance and intervertebral disc in their cervical vertebra film, and transcranial Doppler showed the changes of blood flow. Conclusions Blood supply insufficiency of vertebrobasilar artery was divided into vertebrobasilar transient ischemic attack and vertebrobasilar ischemia according to their clinical symptoms and check - up data. Vertebrobasilar ischemia can cause function disorder of the perfusion area for example brain stem, cerebellum and the back of cerebral hemisphere and so on. These symptoms which appear transiently and repeatedly are often omen of brain stem infarction. We should take strong measures of prevention and health protection to the ischemic cerebrovascular disease. Intervention treatment to improve circulation and remove risk factor also should be taken.