经颅多普勒超声检测头晕患者936例脑血流动力学表现的分析

Clinical analysis of changes of cerebral hemodynamics in the TCD scan results of 936 patients with vertigo

目的探讨头晕患者的脑血流动力学改变特点,为临床诊疗提供参考。方法 936例头晕患者,采用经颅多普勒超声(TCD)仪检测双侧颈内动脉颅外段(EICA)、大脑中动脉(MCA)、大脑前动脉(ACA)、颈内动脉终末段(ICA)、大脑后动脉(PCA)、椎动脉(VA)、基底动脉(BA)。结果936例头晕患者中,312例(33.33%)血流变化异常,624例(66.67%)血流变化正常,不同性别和年龄组间血流变化异常患者所占比率比较,差异有统计学意义(P<0.01)。血流变化异常患者中,前循环血流改变144例、后循环血流改变120例、前后循环血流均改变48例。头晕患者脑血管狭窄前循环改变96例、后循环改变60例。结论头晕患者可合并脑血流动力学改变,部分患者存在脑血管狭窄,临床上不宜简单地把头晕患者诊断为功能性疾病或椎基动脉供血不足。女性血流异常患者比男性多见,>60岁组血流异常患者较多见。头晕患者供血动脉病变中,脑前循环改变比脑后循环改变多见,前循环血管狭窄比后循环血管狭窄多见。

Objective To set a reference for clinical diagnosis by investigating the changes of cerebral hemodynamics of patients with vertigo.Methods Investigate the changes in extracranial internal carotid artery（EICA）,middle cerebral artery（MCA）,anterior cerebral artery（ACA）,posterior cerebral artery（PCA）,internal carotid artery（ICA）,vertebral artery（VA）and basilar artery（BA）by examining 936 patients using Transcranial Doppler system.Results Cases with abnormal blood flow counts to 312（33.33%）while the number of cases with normal blood flow is 624（66.67%）,the differences between gender groups and age groups were both statistically significant（P〈0.01）.Cases with Changes of blood flow in anterior circulation counted 144 while those with changes in posterior circulation counted 120 and the number of those with changes in both circulation was 48.Dizziness and cerebrovascular stenosis occurred in 96 cases while changes in posterior circulation occurred in 60 cases.Conclusion Cerebral hemodynamic changes can occur with or without cerebral vascular stenosis in patiens with vertigo.Clinically,patients with dizziness can not be treated as functional diseases or vertebrobasilar insufficiency.The patients with abnormal blood flow in female is more than male,and more obvious in over 60 years old group.The patients with abnormal blood flow in female is more than male,and more obvious in over 60 years old group.More changes of blood flow as well as cerebrovascular stenosis can be seen in anterior circulation in patients who have the symptom of dizziness.