椎动脉型颈椎病经颅多普勒检测与临床分析

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[摘要] 目的：探讨椎动脉型颈椎病发作间歇期经颅多普勒（TCD）检测结果与临床关系。方法：2010年1月~2011年1月在开封市第一人民医院体检科进行健康体检时行TCD检测2 799人中发现椎动脉型颈椎病患者468例，排除如高血压、糖尿病、脑动脉硬化、出血性及缺血性脑血管病、前日饮酒等可致脑血管收缩期血流速度改变的因素，选取418例作为研究对象，同时按照年龄分层抽取同期行TCD检测的健康者356例作为对照组。使用SPSS 16.0软件包对TCD检测结果进行统计学处理。结果：观察组418例中，颈内动脉系统收缩期血流速度异常者131例；椎动脉（VA）收缩期血流速度异常者386例、基底动脉（BA）收缩期血流速度异常者356例。由统计学分析可知，在去除年龄因素后，男、女椎动脉型颈椎病患病均与椎动脉、基底动脉TCD检测异常有关，女性患者发生VA异常的优势比高于男性患者；女性患者发生BA异常的优势比高于男性患者。结论：TCD检测可作为椎动脉型颈椎病的辅助检查手段，在椎动脉型颈椎病的鉴别诊断及健康管理中发挥作用。

[关键词] 椎动脉型颈椎病；发作间歇期；经颅多普勒；健康管理

[中图分类号] R445.1 [文献标识码] C[文章编号] 1674-4721（2011）07（c）-117-03

TCD inspection and clinical analysis of cervical spondylotic arteriopathy (CSA)

HAN Lili

Department of Health Examination, Kaifeng First People's Hospital, Henan Province, Kaifeng 475001, China

[Abstract] Objective: To discuss the relationship between TCD inspection result and clinical analysis of CSA during the interictal period. Methods: The 468 patients detected with CSA in 2 799 cases by TCD inspection in health examination department of Kaifeng First people's hospital during January 2010 to January 2011 physical examination. Eliminated the factors could cause alteration of cerebrovascular systolic blood flow velocity like hypertension, diabetes mellitus, cerebral arteriosclerosis, ischemic cerebrovascular disease and alcohol consumption one day before. Then selected 418 cases as research object and stratified by age over the same period while taking the TCD detection of 356 healthy cases as the control group. The statistical analysis of TCD inspection results was proceeding by SPSS 16.0. Results: In 418 cases of observation group, there were 131 cases with abnormal blood flow velocity of internal carotid artery system at systole period, 386 cases with abnormal blood flow velocity of vertebral artery (VA) at systole period, and 356 cases with abnormal blood flow velocity of basilar artery (BA) at systole period. Statistical analysis showed that after the removal of age factor, male and female patients with CSA were all have relationship with abnormal TCD inspection. The dominance ratio of female with VA abnormality was higher than male and the BA abnormality was in the same condition. Conclusion: The TCD inspection could use as an auxiliary means of the CSA examination and play an important role in the diagnosis of CSA and the health management.

[Key words] Cervical spondylotic arteriopathy (CSA); During the interictal period; TCD; Health management

椎动脉型颈椎病是颈椎病中常见的一种类型，颈性眩晕是神经学临床较常见的症状之一，也是缺血性脑血管病早期信号或首发症状，对人们健康可造成很大危害。近年来，如何找到一种简便、无创、准确、可重复性好以便于对比分析的影像学检查方法作为诊断和判断疗效的标准，成为该病研究的焦点。经颅多普勒（TCD）由于具有无创、经济、操作简便、可重复性好、灵敏度高等特点，成为椎动脉型颈椎病检测的常用手段之一。为了探讨椎动脉型颈椎病TCD检测结果与临床关系，将2010年1月~2011年1月在开封市第一人民医院体检科进行健康体检时行TCD检测2 799人中发现的椎动脉型颈椎病患者TCD检测结果及临床作以下分析。

1 资料与方法

1.1 一般资料

2010年1月~2011年1月在开封市第一人民医院体检科进行健康体检时行TCD检测2 799人中发现的椎动脉型颈椎病患者共488例，排除如高血压、糖尿病、脑动脉硬化、出血性及缺血性脑血管病、耳源及眼源性眩晕、颅内占位性病变、前日饮酒等可致脑血管收缩期血流速度改变的因素，选取418例作为研究对象，其中，男138例，女280例。年龄最小17岁，最大90岁，均符合颈椎病的分类及诊断标准[1]。同时按照年龄分层随机抽取同期行TCD检测的体检健康者356例作为对照组，其中，男215例，女141例。两组间性别、年龄比较差异无统计学意义。