锁骨下动脉狭窄患者临床症状及DSA表现相关性.docVIP

锁骨下动脉狭窄患者临床症状及DSA表现相关性【摘要】 目的 锁骨下动脉狭窄的临床症状与DSA改变的相关性。方法 DSA证实锁骨下动脉狭窄28例，并把患者分为症状组18例及无症状组10例，分析两组患者的锁骨下动脉狭窄程度、侧支代偿与临床症状的关系。结果 锁骨下动脉狭窄患者狭窄程度与临床症状无关，与侧支代偿有关。结论 DSA能更好明确病变的程度和范围，评估侧支代偿，为临床诊断和治疗提供了的依据。? 【关键词】锁骨下动脉狭窄；椎动脉；锁骨下动脉 Relation between clinical symptoms and the representations of DSA in subclavian stenosis patients YANG Zhi-hua,LIU Lei,TIAN Zuo-jun,et al.The First Affiliated Hospital of Guangzhou Medical Couege Department of Neurology 510260,China ? 【Abstract】 Objective The purpose is to study the relation between clinical symptoms and the representations of DSA in subclavian stenosis patients.Methods 18 Subjects with subclavian stenosis patients were confirmed by the examinations of DSA， and these patients were divided into two groups symptomatic group（18 cases） and asymptomatic group（10 cases），the relation between clinical symptoms and the representations of DSA in subclavian stenosis patients was analysed.Results Clinical symptoms of subclavian stenosis patients were not related with severity of subclavian stenosis，but were related with collateral compensation.Conclusion DSA can help to define the location and severity of the subclavian stenosis lesion and can help to evaluate the colatteral compensation.Therefore，it turn out to be evidence in diagnosis and treatment of subclavian stenosis? 【Key words】Subclavian stenosis;Vertebral artery(VA);Sub-clavian artery(SubA) 锁骨下动脉盗血综合征(subclavian steal syndrome， SSS)是指锁骨下动脉或无名动脉在椎动脉的近心端发生狭窄或闭塞，因虹吸作用引起同侧椎动脉逆流入锁骨下动脉远端， 从而引起椎-基底动脉供血不足的症状，以眩晕及视觉障碍最常见，次为晕厥。本病临床并非少见，约占短暂性脑供血不足病因的1%~4%。国内外的研究表明锁骨下狭窄程度与症状无明确的关系[1-2]，本文就DSA诊断28例锁骨下动脉狭窄的患者的DSA影像学特征进行分析，并对其症状的相关影响因素进行探讨，现报告如下。 1 资料与方法 1．1 一般资料 本文收集了2006年1月至2008年6月收治的住院的经DSA证实锁骨下动脉狭窄28例，其中男16例，女12例;年龄最大79岁 ，最小为50岁，平均62岁。28例均经动脉血管造影检查并证实诊断。其中有高血压病史15例，糖尿病病史10例，高血压合并糖尿病病史3例。根据患者有无后循环缺血或上肢运动时缺血等症状，分为症状组和无症状组，症状组患者临床表现可为患侧上肢运动时易疲劳，肢体发凉，疼痛，脉搏减弱，收舒压血压低于健侧(4．00 kPa以上)同时还可伴有眩晕，视觉障碍等神经症状。 1．2 DSA检查 先以猪尾导管配合泥鳅导丝，进行主动脉弓造影，以观察主动脉弓、弓上血管开口及近心端血管形态及血流状况，然后在泥鳅导丝的引导下，