彩色多普勒超声在大动脉炎患者锁骨下动脉受累中的诊断价值

Diagnostic value of color Doppler ultrasonography for subclavian artery involvement in patients with Takayasu＇s arteritis

目的 探讨彩色多普勒超声在大动脉炎锁骨下动脉受累中的诊断价值.方法 选取山西省人民医院2016年3月至2018年3月收治的82例大动脉炎锁骨下动脉受累患者设为研究组,另选取同期85例健康体检者纳入对照组.应用二维及彩色多普勒超声、脉冲多普勒超声观察研究组病变段血管的形态学及血流动力学改变,并与对照组进行比较.结果 研究组病变段血管声像图典型表现为对称的内-中膜弥漫性增厚,管腔不同程度狭窄甚至闭塞,且病变段血管内-中膜厚度与对照组比较差异有统计学意义[（2.75±0.87）mm比（0.67±0.34）mm,t=20.212,P〈0.001].脉冲多普勒显示病变段血管相应血流动力学改变,频谱示狭窄处血流多数显示出加速,少数血流速度减慢.研究组病变段血管血流速度与对照组比较差异有统计学意义[（187.92±86.28）cm/s比（110.58±57.45）cm/s,t=6.793,P〈0.001].结论 彩色多普勒超声能准确反映大动脉炎锁骨下动脉受累的病变段血管的变化,可为临床大动脉炎锁骨下动脉受累提供可靠的诊断依据.

Objective To investigate the value of color Doppler uhrasonography in the diagnosis of subclavian artery involvement in the Takayasu＇s arteritis patients. Methods Eighty-two Takayasu＇s arteritis patients with subclavian artery involvement treated in Shanxi Provincial People＇s Hospital from March 2016 to March 2018 were selected as research group, and 85 healthy cases in the same period were selected as control group. The morphological and hemodynamic changes in vascular lesion of research group were observed by two-dimensional ultrasonography and color Doppler uhrasonography, and these data were compared with the control group. Results In researth group,the vascular ultrasound images of the vascular lesion were characterized by the diffuse thickening of intima-media （IMT） , stenosis of differenc degrees, and there might even be occlusion of the vascular cavity. The thickness of the intima-media of research group was significantly different from that of control group [ （2. 75 ± 0. 87） mm vs. （0. 67 ±0. 34 ） mm, t = 20. 212, P 〈 0. 001 ]. Pulse Doppler ultrasonography showed the hemodynamic changes in the lesion segment. The velocity of the blood flow were accelerated when arterial stenosis was presented, but a few ones showed low blood velocity. There was a significant difference in blood flow velocity between research group and control group [ （187.92 ± 86.28 ）cm/s vs. （110. 58 ± 57.45 ）cm/s, t = 6. 793,P 〈 0. 001 ]. Conclusions Color Doppler uhrasonography can accurately reflect the changes of the vessels of the subclavian artery involved in Takayasu＇s arteritis, and can provide a reliable basis for diagnosis of subclavian artery involved by Takayasu＇s arteritis.