超声对脑血管狭窄与血管反应性的评价

Untrasonic evaluation of cerebrovascular stenosis and vasomotor reactivity

目的:探讨脑血管狭窄及血管反应性(VMR)在眩晕症状中的相关性。方法:选取行经颅多普勒超声检查且无其他神经体征的头晕或眩晕患者156例,正常对照组48例。于平静呼吸探查脑血管颅外段(ICA、VA)及颅内段(V-BA、MCA、ACA、PCA)的血流动力学指标;颈部血管内中膜(IMT)、狭窄程度及屏气(>15s)颈内动脉平均速度(MFV),计算VMR。比较各组间脑血管狭窄、VMR,对VMR与年龄、血压、空腹血糖、IMT进行多元线性回归分析。结果:脑血管狭窄眩晕组明显高于头晕组(P<0.05);单纯椎-基底动脉系统血管狭窄率眩晕组高于头晕组(P<0.05);头晕组、眩晕组VMR明显低于对照组(P=0.001、P=0.003);眩晕组VMR与年龄、收缩压、空腹血糖和IMT厚度有明显相关性。结论:眩晕患者脑血管狭窄率高于头晕患者,以椎-基底动脉系统为主,头晕及眩晕患者VMR降低,VMR与年龄、收缩压、空腹血糖和IMT厚度呈负相关。

Objective：To evaluate the relationship between dizziness and the stenosis of cerebrovascular,vascular motor reactivity （VMR）.Methods：A total of 204 patients were divided into three groups according to the clinical symptoms,the extracranial segment of the cerebral arteries （ ICA, VA） and intracranial arteries （ACA, MCA, PCA ,V-BA） were observed when calm breathe and 14olding back breath （〉15 s） with CDFI and TCD. The velocity and vasomotor reactivity were analysed. Results：The stenosis of cerebrovascular was higher in vertigo than that of dizziness （P=0.021）,the stenosis of V-BA was magnifant in vertigo （P=0.019）. The vasoreactivity in vertigo and dizziness was significantly lower than that in controls（P=0.001 ,P--0.003）. The vasoreactivity of vertigo was associated closely with intima-media thickness,age, blood glucose,systolic blood pressure.Conclusion：The stenosis of cerebral arteries is higher in vertigo patients than dizziness patients and the stenosis of V-BA is magnifant,the vasomotor reactivity of dizziness and vertigo patients is lower. The vasoreactivity of vertigo is associated closely with blood glucose, systolic blood pressure,intima-media thickness and age.