血管及血流动力学异常与后循环缺血的相关性分析

On the Correlation between the Abnormality of the Blood Vessel and Hemodynamics and Posterior Circulation Ischemia

目的探讨血管及血流动力学异常与后循环缺血（pcI）的相关性。方法临床确诊为后循环缺血的病人110例,采用64层CTA或MRA观察血管狭窄、变异分布情况，对头颅CTA或MRA未见后循环血管异常者采用彩色多普勒超声探查，测量血流参数：收缩期峰值流速（PSV）、舒张末期血流速度（EDV）。结果后循环缺血者中CTA或MRA检查发现血管异常较对照组明显增加（P〈0．001）。血管异常67例，包括血管狭窄50例、发育异常17例，其中左椎动脉狭窄占28％。未见后循环血管异常者43例包括颈内动脉系统异常17例，其椎动脉的PSV、PSV／EDV均较对照组显著降低（P〈0．05）。结论血管狭窄、发育异常、椎动脉血流动力学改变是后循环缺血的主要原因，血管异常中以左椎动脉狭窄为主，颈内动脉系统异常是导致后循环缺血主要原因之一。

Objective To investigate the correlation between the abnormal artery and its hemodynamics and posterior circulation isehemia（PCI）.Methods A sample of 110 patients with confirmed posterior circulation is- ehemia is taken in this experiment to observe the distribution of angiostenosis and vascular variation by using 64 CTA or the MRA.Ifposterior circulation isehemia of abnormal artery is not observed,colored Doppler supersonic is then used to measure the related blood stream parameters：peak systolic velocity （PSV）,end diastolic velocity （EDV）. Results While CTA or the MRA tests show that vascular abnormality occurs more frequently among this group compared with the control group （P〈0.001）.The abnormality of the blood vessel is in 67 cases.50 eases have angiostenosis symptom with 17 cases of angiodysplasia and the left arteria vertebralis narrow accounts for 28%. Another 43 cases bear no abnormality of blood vessel, including 17 cases of carotid artery system abnormality.Of these 43 eases, the PSV, PSV/EDV of their vertebrobasilar artery is reduced significantly compared with the control group （P〈0.05）.Conclusion Angiostenosis,angiodysplasia and arteria vertebralis hemodynamic changes are the primary causes of PCI.The left arteria vertebralis narrow is the most in the abnormality of the blood vessel. Carotid artery system abnormality is one of the primary causes in the PCI.