[1]梁毅仪,丘丽雅,谢静芳.锁骨下动脉狭窄合并椎动脉狭窄性病变可导致对侧椎动脉代偿性血流减少[J].南方医科大学学报,2018,(12):1509.[doi:10.12122/j.issn.1673-4254.2018.12.18]
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锁骨下动脉狭窄合并椎动脉狭窄性病变可导致对侧椎动脉代偿性血流减少()
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《南方医科大学学报》[ISSN:1673-4254/CN:44-1627/R]

卷:
期数:
2018年12期
页码:
1509
栏目:
出版日期:
2018-12-31

文章信息/Info

Title:
Subclavian artery stenosis combined with vertebral artery stenosis may lead to compensatory blood flow changes in the contralateral vertebral artery
作者:
梁毅仪丘丽雅谢静芳
关键词:
椎动脉锁骨下动脉盗血综合征超声检查多普勒经颅
Keywords:
vertebral artery subclavian steal syndrome ultrasonography Doppler transcranial
DOI:
10.12122/j.issn.1673-4254.2018.12.18
摘要:
目的探讨锁骨下动脉狭窄合并椎动脉狭窄性病变的盗血程度及血流动力学情况。方法回顾性分析2014年2月~2018 年7月合并单侧或双侧椎动脉狭窄(狭窄程度大于50%)或闭塞的锁骨下动脉狭窄患者(合并椎动脉狭窄性病变组,37例)的经 颅多普勒超声资料,总结其盗血类型、病变锁骨下动脉收缩期峰值流速、对侧椎动脉收缩期峰值流速及束臂试验结果,以无合并 椎动脉狭窄性病变的锁骨下动脉狭窄患者为对照组(39例),比较各组间盗血程度及血流动力学的差异。结果合并椎动脉狭窄 性病变组盗血情况如下:无盗血5例,Ⅰ期22例,Ⅱ期7例,Ⅲ期3例。对照组:Ⅰ期17例,Ⅱ期12例,Ⅲ期10例。两组盗血程度 比较差异有统计学意义(H=9.431,P=0.002)。合并椎动脉狭窄性病变组的对侧椎动脉收缩期峰值流速为43.91±17.43 cm/s。与 对照组53.56±17.45 cm/s 相比差异有统计学意义(t=629.5,P=0.006)。合并椎动脉狭窄性病变组的束臂试验阴性率为35.1% (13/37),对照组的束臂试验阴性率为7.7%(3/39),两组比较差异有统计学意义(χ2=8.603,P=0.003)。结论锁骨下动脉狭窄合 并椎动脉狭窄性病变可导致对侧椎动脉代偿血流减少,锁骨下动脉盗血程度减轻。
Abstract:
Objective To investigate the severity of blood steal and the hemodynamic profiles in patients with subclavian artery stenosis combined with vertebral artery stenosis. Methods A retrospective analysis was performed of transcranial Doppler (TCD) data from patients with subclavian artery stenosis (SAS) and concomitant unilateral/bilateral vertebral artery stenosis (VAS, >50%) or occlusion in our institution between February, 2014 and July, 2018. Thirty-seven patients with SAS combined with VAS (SAS+VAS) were reviewed for types of blood steal, peak systolic velocities of blood flow in affected subclavian artery and the contralateral vertebral artery, and the findings of hyperemia testing. These data were also reviewed for 39 SAS patients without VAS (control group) for comparison of blood steal and hemodynamic profiles. Results In SAS+VAS group, 5 patients showed no blood steal; blood steal in stage I was found in 22 patients, stage II in 7, and stage III in 3, as compared to the numbers of 17, 12 and 10 in the control group, respectively (H=9.431, P=0.002). The peak systolic velocity of the contralateral vertebral artery was 43.91±17.43 cm/s in SAS+VAS group, significantly lower than that in the control group (53.56±17.45 cm/s; t= 629.5, P=0.006). Hyperemia testing showed a significant difference in the negative rate between SAS + VAS group and the control group [35.1% (13/37) vs 7.7% (3/39); χ2=8.603, P=0.003). Conclusion SAS combined with VAS may lead to reduced compensatory blood flow in the contralateral vertebral artery to lessen the severity of subclavian steal syndrome.

相似文献/References:

[1]樊俊,黄胜平.椎动脉窗式变异的成因及临床意义(附1例报道)[J].南方医科大学学报,2004,(04):477.
 FAN Jun,HUANG Sheng-ping.Origin and clinical significance of the vertebral arterial fenestration:report of a case[J].Journal of Southern Medical University,2004,(12):477.

更新日期/Last Update: 1900-01-01