锁骨下动脉与椎动脉病变所致椎动脉反流超声鉴别诊断分析

The ultrasound differential diagnosis analysis of vertebral artery reflux caused by subclavian artery and vertebral artery lesions

目的探讨不同病变部位引起椎动脉(VA)反流时的血流动力学差异。方法选取经彩色多普勒超声检查发现VA血流频谱出现反向血流,并准确诊断病变部位的125例患者。据病变部位不同分成锁骨下动脉(SA)病变组和VA病变组对比观察。结果 SA病变组81例,VA病变组44例,两组间VA频谱类似者对比,SA组VA流速较VA组高(P<0.05)。SA组较VA组病变侧上肢动脉频谱改变发生率高;病变侧流速较健侧低,AT延长(P<0.05)。VA组双侧上肢动脉流速及AT差异无统计学意义(P>0.05)。束臂试验阳性率SA组较VA组高(P<0.05)。结论 VA反流可由锁骨下动脉或无名动脉或椎动脉狭窄或闭塞引起,结合病变侧椎动脉流速、上肢动脉血流动力学变化及束臂试验,可提高鉴别诊断。

Objective To explore the haemodynamies changes of vertebral artery（VA） reverse flow caused by different le- sion. Methods The color Doppler ultrasound findings of vertebral artery flow spectrum appeared the reverse flow components,and 125 cases were accurately diagnosed lesion patients. According to the lesion site, the cases were divided into subclavian artery（SA） group and VA group. Results In 125 patients,there were 81 patients with SA,44 patients with VA. Two groups with similar VA spectrum were compared,and the velocity in SA group was higher than that of VA group （P〈0.05）. The upper extremity artery of the SA group on the side of the lesion had the higher spectrum changing rate,lower flow velocity and longer AT than those of VA group （P〈0. 05）. The difference of the.flow velocity of bilateral upper limb artery and the AT in VA group was not statistically significant（P〉0.05）. The positive rate of arm beam test in SA group was higher than that of VA group（P〈0.05）. Conclusion Vertebral artery reflux may be caused by subclavian artery or renominate artery and vertebral artery stenosis or occlusion. Combina- tion of lesion side vertebral artery flow velocity, the upper limb arterial blood flow dynamic change and arm beam test can improve diagnostic accuracy.