交感神经型颈椎病疗效与影像学改变的相关性研究

Correlation study between the efficacy of sympathetic cervical spondylosis and the changes of imaging

目的分析交感神经型颈椎病治疗前后的相关影像学改变，探讨其影像学改变与疗效的相关性。方法收集住院治疗且同时经x线、CT、经颅多普勒（TCD）或彩色多普勒血流显像（CDFI）检查的交感神经型颈椎病患者71例，经综合治疗后，根据患者症状恢复情况评价疗效，且对影像学异常的病例复查，分析影像学改变与疗效的相关性。结果71例患者治疗后优45例，良18例，可8例，优良率88．7％（63/71），有效率100．0％（71/71）。复查相关影像：36例寰枢关节半脱位CT复查结果正常26例，改善6例，无改变4例；68例异常x线复查结果改善67例，无改变1例；38例异常TCD复查结果正常24例，改善2例，变化10例，无改变2例；36例颈部CDFI异常复查结果正常9例，改善10例，变化15例，无改变2例。影像学改变与疗效相关性分析：变化按数值0计，r=0．388，t=3．500，P〈0．01；变化按数值0．5计，r=0．361，t=3．211，P〈0．01。结论交感神经型颈椎病疗效与影像学改变呈正相关；且交感神经型颈椎病的病因复杂，系统检查能够发现不同的病因，有利于辨证治疗，并可印证疗效。

Objective To analyze the changes of imaging and the efficacy of sympathetic cervical spondylosis before and after treatment and discuss the correlation of them. Methods Seventy-one sympathetic cervical spondylosis inpatients who examined by X-ray, CT, transcranial Doppler （TCD） or color Doppler flow imaging（CDFI） were collected. After comprehensive treatment, the efficacy was evaluated according to the recovery of patients＇ symptoms, and the cases with imaging abnormalities were examined again. Then the correlation between the changes of imaging and the efficacy was analyzed. Results After treatment, all 71 cases,including 45 cases with excellent efficacy, 18 cases with good effect and 8 cases turned effective, showed a fine rate 88.7% （63/71） and an effective rate 100.0% （71/71）. The rechecked imaging results showed： in 36 lantoaxial subluxation cases by CT scanning, 26 cases turned to be normal, 6 cases were improved and 4 cases had finally no change; in 68 cases with abnormal X-ray imaging, 67 cases were improved and 1 case had finally no change; in 38 cases with abnormal TCD results, 24 cases turned to be normal, 2 cases were improved, 10 cases showed changes and 2 cases had finally no change;in 36 cases with abnormal cervical CDFI results, 9 cases turned to be normal, 10 cases were improved, 15 cases showed changes and 2 cases had finally no change. The analysis of correlation between the changes of imaging and the efficacy showed： changes count by the value 0, r = 0.388, t = 3.500, P 〈 0.01 ; changes count by the value 0.5,t = 0.361 ,t = 3.211 ,P 〈 0.01. Conclusions The efficacy of sympathetic cervical spondytosis has positive correlation with the changes of imaging and the causes of this disease are complex. So complete and well inspection can help the syndrome differentiation treatment and confirm the efficacy.