锁骨下动脉窃血综合征椎动脉多普勒频谱特征与锁骨下动脉狭窄的关系

Correlation of vertebral artery Doppler spectrum features and subclavian artery stenosis in subclavian steal syndrome

目的分析锁骨下动脉窃血综合征椎动脉血流频谱特征及血流速度与锁骨下动脉狭窄程度的关系。方法将50例确诊的锁骨下动脉窃血综合征患者按锁骨下动脉狭窄程度分为3组,分析患者椎动脉血流频谱特征及收缩期血流速度,比较各组间上述指标的差异。结果①椎动脉Ⅰ度窃血多普勒频谱主要表现为收缩中晚期流速下降;椎动脉Ⅱ度窃血主要表现为收缩期血流反向;椎动脉Ⅲ度窃血主要表现为收缩期和舒张期血流均反向。②与轻中度狭窄组比较,锁骨下动脉重度狭窄组及闭塞组患侧椎动脉收缩期峰值流速减低,且以闭塞组更为明显;与轻中度狭窄组比较,锁骨下动脉重度狭窄组及闭塞组健侧椎动脉收缩期峰值流速增加。结论患侧椎动脉多普勒血流频谱特征及收缩期峰值流速可以间接反应锁骨下动脉狭窄程度。

Objective To observe the vertebral arterial Doppler spectrum features and velocities in patients with subclavian steal syndrome（SSS）.Methods Fifty patients with SSS were divided into three groups;the features of Doppler spectrum and velocity of vertebral artery in systole were analyzed.Results The affected vertebral arterial mild-to-late systolic velocity decreased in patients with stage Ⅰ steal;the systolic retrograde vertebral arterial flow was evident in patients with stage Ⅱ steal,while in patients with stage Ⅲ steal;both systolic and diastolic retrograde vertebral arterial flow were evident.The affected vertebral arterial systolic velocity decreased in patients with subclavian arterial severe stenosis and occlusion when compared with patients with mild-to-moderate stenosis,and further decreased in patients with subclavian arterial occlusion.The non-affected vertebral arterial systolic velocity increased in patients with subclavian arterial severe stenosis and occlusion when compared with patients with mild-to-moderate stenosis.Conclusion The involvement extent of subclavian artery stenosis can be reflected by the features of Doppler spectrum and systolic velocity of affected vertebral artery in patients with SSS.