锁骨下动脉窃血综合征患者椎动脉血流改变的彩色多普勒超声评价

Evaluation of hemodynamic changes of bilateral vertebral arteries in patients with subclavian steal syndrome by color doppler ultrasound

目的分析彩色多普勒超声评价锁骨下动脉窃血综合征(SSS)患者椎动脉血流改变情况.方法选取2012年9月~2019年4月收治的46例SSS患者,患者入院后均实施彩色多普勒超声检查,分析患者的椎动脉血流动力学变化.结果窃血程度与锁骨下动脉狭窄程度呈正相关(r=0.754,P=0.000),患侧、健侧不同窃血程度的椎动脉收缩期峰值流速(Vp)、搏动指数(PI)差异明显(P<0.05),健侧Ⅲ期窃血椎动脉Vp、PI>Ⅱ期>Ⅰ期>无窃血(P<0.05),患侧Ⅲ期窃血椎动脉的Vp、PI<Ⅱ期<Ⅰ期<无窃血(P<0.05),患侧椎动脉Ⅰ、Ⅱ、Ⅲ期窃血的Vp、PI均低于健侧(P<0.05),无窃血患侧与健侧Vp、PI比较差异不显著(P>0.05).结论 SSS患者窃血程度与锁骨下动脉狭窄程度有关,且患侧窃血程度越严重,健侧椎动脉血流动力学速度越快,彩色多普勒超声可对SSS椎动脉的血流动力学进行准确的评价.

Objective To analyze hemodynamic changes of bilateral vertebral arteries in patients with subclavian steal syndrome( SSS) by color doppler ultrasound. Methods 46 patients with SSS were selected from September 2012 to April 2019. All patients were examined by color doppler ultrasound after admission, and the hemodynamic changes of bilateral vertebral arteries were analyzed. Results The degree of stealing blood was positively correlated with the degree of subclavian artery stenosis( r = 0.754, P = 0.000). The peak systolic velocity( Vp) and pulsatility index( PI) of vertebral arteries were significantly different between the affected side and the healthy side( P < 0.05). Vertebral artery Vp, PI stage Ⅲ stealing blood > stage Ⅱ> stage Ⅰ> no stealing in healthy side( P < 0.05). The Vp and PI of the vertebral arteries in stage Ⅲ stealing < stage Ⅱ< stage Ⅰ< no stealing in affected side( P < 0.05). The Vp and PI of the affected vertebral arteries in stage Ⅰ,Ⅱ and Ⅲ were lower than those of the healthy side( P < 0.05). There was no significant difference in Vp and PI between the affected side and the healthy side( P > 0.05). Conclusion The degree of stealing blood in SSS patients is related to the degree of subclavian artery stenosis. The more serious the stealing blood is, the faster the hemodynamic velocity of the healthy side will be. Color Doppler ultrasound can accurately evaluate the hemodynamics of the SSS vertebral arteries.