椎动脉收缩期切迹对早期锁骨下动脉窃血综合征的诊断价值.doc

椎动脉收缩期切迹对早期锁骨下动脉窃血综合征的诊断价值 　　作者：刘佳明,敖颖　　作者单位：禅城区中心医院，广东 佛山 　　【摘要】目的：应用彩色多普勒超声和束臂试验证实椎动脉收缩期切迹可诊断早期锁骨下动脉窃血综合征。方法 ：通过对20例椎动脉正常组(无切迹组)及椎动脉收缩期切迹组进行束臂试验，比较试验前后同侧椎动脉血流方向和多普勒频谱变化，椎动脉收缩期切迹组每例患者均同时行DSA检查证实。结果： 束臂试验前后，20例椎动脉正常组同侧椎动脉血流方向和多普勒频谱无明显变化;20例椎动脉收缩期切迹组同侧椎动脉血流方向无逆流(14例)或出现部分逆流(6例)，收缩期流速下降幅度增大及持续时间明显延长。两组束臂前后椎动脉收缩期流速下降幅度及持续时间有显著差异。 结论：椎动脉收缩期切迹对早期锁骨下动脉窃血综合征具有重要的诊断价值。 　　【关键词】椎动脉,锁骨下动脉窃血综合征,彩色多普勒超声 　　【Abstract】Objective：color Doppler ultrasound and vertebral artery beam arm tests confirm the diagnosis of early systolic notch may subclavian steal syndrome. Methods: 20 cases of vertebral artery and normal group (without notch group) and vertebral artery systolic notch group beam arm trial to compare ipsilateral vertebral artery blood flow before and after testing the direction and Doppler frequency spectrum changes， vertebral artery systolic Each notch group of patients were confirmed as the same time-line DSA. Beam-arm test results before and after the normal group， 20 cases of vertebral artery ipsilateral vertebral artery blood flow direction and Doppler frequency spectrum no significant change; 20 cases of vertebral artery systolic notch group of ipsilateral vertebral artery blood flow in the direction of non-reflux (14 cases) or there part of the reflux (6 cases)， greater decrease in systolic velocity and duration was significantly prolonged. Two-beam arm vertebral artery before and after the decrease in systolic velocity and duration were significantly different. Conclusions: The vertebral artery systolic notch on the early subclavian steal syndrome has important diagnostic value. 　　【Key words】 Vertebral artery; Subclavian steal syndrome; Color doppler ultrasound 锁骨下动脉窃血综合征(subclavian steal syndrome)通常是由于动脉粥样硬化或大动脉炎，使锁骨下动脉起始段或无名动脉狭窄或闭塞，导致脑血流经 willis 动脉环，再经同侧椎动脉虹吸引流，使部分脑血流逆行灌入患侧上肢，从而引起脑局部缺血[1]。本文通过束臂试验对椎动脉收缩期切迹组与正常组(无切迹组)进行对比，证实椎动脉收缩期切迹可提示早期锁骨下动脉窃血综合征。 　　1资料与方法 　　1.1 一般资料 　　20例有切迹组为2008年1月至2009年12月在我院超声检查中发现椎动脉收缩期切迹者，其中男15例，女5例，年龄50～89岁，平均63岁。