754例头晕患者经颅多普勒与颈部血管超声检查结果对比分析

Transcranial Doppler findings versus cervical vascular ultrasound findings in patients with a chief complaint of dizziness:A comparative analysis of 754 cases

目的探讨经颅多普勒(TCD)与颈部血管超声(CVUS)在门诊头晕患者中的诊断价值。方法回顾性对比分析神经内科门诊754例主诉头晕患者的TCD及CVUS检查结果。结果CVUS的异常检出率显著高于TCD(c2=165.517,P<0.001);与单一检查方法相比,CVUS联合TCD检查的异常检出率更高(72.02%)。两种方法对血管狭窄或闭塞的检出率无差异(P=0.211),联合两种检查方法可以显著提高血管狭窄的检出率。年龄对头晕患者出现血流参数异常具有一定的预测价值(P<0.001)。CVUS能更早的识别头晕患者血管异常状态。结论联合CVUS和TCD检查有助于发现门诊头晕患者脑血管异常;头晕患者年龄越大,更易出现脑血流动力学异常,但由血管狭窄引起的脑供血不足并不是门诊头晕患者主要的致病原因。

Objective To investigate the diagnostic value of transcranial Doppler(TCD)and cervical vascular ultrasound(CVUS)in outpatients with a chief complaint of dizziness.Methods A retrospective analysis was performed for the TCD and CVUS findings of 754 patients with a chief complaint of dizziness in the outpatient service of Department of Neurology.Results CVUS had a significantly higher abnormal detection rate than TCD(c2=165.517,P<0.001),and CVUS combined with TCD had a higher abnormal detection rate(72.02%)than CVUS or TCD alone.The two methods had a similar detection rate of vascular stenosis or occlusion(P=0.211),and the combination of CVUS and TCD significantly increased the detection rate of vascular stenosis.Age had a certain value in predicting abnormal blood flow parameters in the patients with dizziness(P<0.001),and CVUS could identify the abnormal state of blood vessels in patients with dizziness earlier.Conclusions TCD combined with CVUS can help to identify cerebrovascular abnormalities in outpatients with dizziness.Older patients with dizziness aremore likely to have abnormal cerebral hemodynamics,but insufficient cerebral blood supply caused by vascular stenosis is not the main cause of dizziness in outpatients.