突发性聋患者椎-基底动脉血流动力学观察

The Vertebral Artery and Basilar Artery Haemodynamics of Sudden Deafness

目的探讨不同频率突发性聋患者的椎-基底动脉血流动力学改变特点。方法以90例突发性聋患者为研究对象,根据听阈曲线类型分为低中频下降组、高频下降组及全频下降组,每组30例,正常对照组30例,各组均行经颅多普勒(transcranial doppler,TCD)检查,探测双侧椎动脉(vertebral artery,VA)、基底动脉(basilar artery,BA),分别记录比较各组收缩期流速(systolic velocity,Vs)、舒张期流速(diastolic velocity,Vd)、脉冲指数(pulsitility index,PI)、阻力指数(resistance index,RI)。结果①低中频组、高频组、全频组突聋患者椎-基底动脉血流异常率分别为63.33%(19/30)、90.0%(27/30)和90.0%(27/30),对照组异常率为0%,高频及全频组患者血流异常率较低中频组高(P<0.05);高频组患者VA、BA以高流速检出较多,全频组患者低流速检出较多(P<0.05)。②突发性聋患者VA、BA的PI、RI与对照组比较差异无统计学意义(P>0.05),高频组VA、BA的Vs、Vd均高于对照组(P<0.05),低中频组BA的Vs高于对照组(P<0.05)。结论突聋患者尤其是高频、全频听力下降者椎-基底动脉血流动力学异常率明显增加。

Objective To explore different characteristics of the vertebral artery and basilar artery haemody-namics in different frequencies to provide a theoretical basis for clinical treatment .Methods 90 cases of sudden deaf-ness were induded and according to hearing curve ,the cases were divided into three groups with 30 cases for each while the control group had 30 subjects .All cases were examined by TCD ,the VA ,BA test .Results Compared with group of median and low frequency sudden deafness ,the abnormal blood flow rate were found with decreased hearing（P〈0 .05） .High and the full frequency range showed the abnormal blood flow rate ,although results were different（P〈0 .05） .There were more high velocity detection rates among patients of high frequency group than the other groups .The full-frequency group＆#39;s blood flow detection rate increased significantly more than the first two groups of patients with sudden deafness .PI ,RI of sudden deafness increased slightly ,but there was no statistically significant difference compared with control group （P〉0 .05） .High frequency hearing loss compared with the con-trol group patients with sudden deafness had a clear abnormal velocity （P〈0 .05） ,characterized by high velocity . There was no statistically significant difference in blood flow rate among low and median frequency group ,full-fre-quency group and control group except for Vs of BA in low and median frequency group .Conclusion Vertebral and basilar arterial circulation disorders had present more significance in the incidence of sudden deafness ,evident espe-cially in high and all frequency sudden deafness .Early initiation of TCD examination can understand the change of the vertebral and basilar artery hemodynamics ,providing high clinical application values .