TCD及转颈试验对椎基底动脉供血不足的研究

Study of TCD and Neck Rotation Test for Vertebrobasilar Insufficience

目的 :探讨TCD及转颈试验对椎基底动脉供血不足 (VBI)的诊断价值 .方法 :对 94例经临床确诊的VBI患者进行TCD及转颈试验检查 ,并与 6 8例健康对照组进行对比 .结果 :94例患者TCD异常 74例 ,异常率78 7% ,加做转颈试验后异常率为 84 1% .主要异常表现为椎基底动脉系血流速度异常、血流频谱改变及PI值增高 .流速异常中流速增高占 34 %、流速降低占 43 6 %、流速正常占 2 2 4% .流速降低组患者平均年龄低于流速增高组 (P <0 0 1)及流速正常组 (P <0 0 5 ) .转颈试验后各流速组的平均血流速度均较转颈前显著降低 (P <0 0 1～ 0 0 5 ) ,而对照组转颈前后血流速度无显著性差异 .结论 :TCD可无创地检测VBI患者的血流动力学异常 ,具有较高的敏感性 。

Objective: To determine the diagnostic value of TCD and neck rotation test in vertebrobasilar insufficience (VBI). Methods: 94 patients of VBI by clinical confirmed and 76 normal controls were performed transcranial Doppler ultrasonography (TCD) and neck rotation test. Result: 74 patients (78.7%) were found abnormality by TCD, after been performed neck rotation test, the abnormal cases increased to 79(84.1%). The main abnormalities were blood flow velocity and spectrum abnormalities and the increasing value of pulsatility index (PI). The rate of increasing blood flow velocity was 34%, the rate of decreasing blood flow velocity was 43.6%, and the rate of normal blood flow velocity was 22.4%. The mean age for decreasing velocity subgroup was older than the increasing velocity subgroup (P<0.01) and normal velocity subgroup (P<0.05). After neck rotation test, the velocity of 3 subgroups was lower than the basiline (P<0.01～0.05), whereas there was no significant difference in controls. Conclusion: TCD could sensitively detect the hemodynamic abnormalities of VBI, and the neck rotation test could indicate the positive rate especially in the early stage.