CAJ | 학술논문

目的评价椎动脉发育不良与脑动脉后循环血流灌注量的关系,为椎动脉发育不良患者后循环缺血性病变及症状提供血流动力学±据。方法选取椎动脉发育不良患者53例,正常对照组60例,进行椎动脉超声检查,测量椎动脉内径( vertebral artery diameter,VAD),收缩期流速(peak systolic velocity,PSV),舒张期流速(end diastolic velocity,EDV),阻力指数(resistance index,RI),流速时间积分( velocity-time integral,VTI)、心率( heart rate,HR),并计算血管截面积( A)及血流量( Q),分析椎动脉发育不良对后循环血流灌注量的影响。结果病例组后循环血流量为(299.83±58.52) mL/min,对照组为(351.26±49.17) mL/min,两组间比较,差异具有统计学意义(P<0.05)；病例组发育不良侧椎动脉平均血流量(47.57±18.41)mL/min、舒张期流速(11.46±3.97)cm/s、阻力指数0.78±0.09,与健侧椎动脉及对照组左右侧椎动脉比较,差异有统计学意义(P<0.05)；发育不良侧椎动脉的血流量与椎动脉内径呈高度正相关性(R2=0.8878),而与阻力指数呈高度负相关性(R2=0.8494)。结论发育不良侧椎动脉的血流量明显减低,虽然健侧存在代偿,但后循环总血流灌注量仍较健康人显著减低,椎动脉发育不良是后循环缺血性病变的潜在危险因素。
목적평개추동맥발육불량여뇌동맥후순배혈류관주량적관계,위추동맥발육불량환자후순배결혈성병변급증상제공혈류동역학±거。방법선취추동맥발육불량환자53례,정상대조조60례,진행추동맥초성검사,측량추동맥내경( vertebral artery diameter,VAD),수축기류속(peak systolic velocity,PSV),서장기류속(end diastolic velocity,EDV),조력지수(resistance index,RI),류속시간적분( velocity-time integral,VTI)、심솔( heart rate,HR),병계산혈관절면적( A)급혈류량( Q),분석추동맥발육불량대후순배혈류관주량적영향。결과병례조후순배혈류량위(299.83±58.52) mL/min,대조조위(351.26±49.17) mL/min,량조간비교,차이구유통계학의의(P<0.05)；병례조발육불량측추동맥평균혈류량(47.57±18.41)mL/min、서장기류속(11.46±3.97)cm/s、조력지수0.78±0.09,여건측추동맥급대조조좌우측추동맥비교,차이유통계학의의(P<0.05)；발육불량측추동맥적혈류량여추동맥내경정고도정상관성(R2=0.8878),이여조력지수정고도부상관성(R2=0.8494)。결론발육불량측추동맥적혈류량명현감저,수연건측존재대상,단후순배총혈류관주량잉교건강인현저감저,추동맥발육불량시후순배결혈성병변적잠재위험인소。
Objective To extend our knowledge of the congenital disease, this study attempted to assess the diagnostic value of posterior cerebral circulation in vertebral artery hypoplasia(VAH) detected by color Doppler flow imaging(CDFI), as well as to provide hemodynamic data for posterior circulation ischemia in VAH. Methods Fifty-three patients with vertebral artery hypoplasia and 60 healthy controls confirmed by color Doppler sonography were enrolled into this study. Vertebral artery diameter(VAD), peak systolic velocity(PSV), end diastolic velocity (EDV), resistance index(RI), velocity-time integral(VTI) and heart rate(HR) were measured. Vessel areas and blood flow volume were calculated. Variation of the difference of the results between the case and control groups was analyzed to assess the effect of congenital VA hypoplasia on posterior circulation. Results A comparison between the case and control groups showed that the blood flow of posterior circulation in case group was lower compared with the control group(299. 83±58. 52) mL/min vs (351. 26±49. 17) mL/min(P<0. 05). The average blood flow of dysplasia side was(47. 57±18. 41) mL/min. Diastolic velocity was(11. 46±3. 97) cm/s and the resistance index was(0. 78±0. 09). There was statistical different between the dysplasia side and the contralateral normal side, and between the case and control groups(P<0. 05). Moreover, the posterior circulation flow in the case group was positively correlated with the vertebral artery diameter(R2=0. 887 8), and negatively correlated with the resistance index(R2=0. 849 4). Conclusion Obviously reduced cerebral blood flow was associated with VAH. In spite of the existence of uninjured side compensation, the total perfusion of posterior circulation was still lower than that of the control group. Color Doppler sonography not only images the congenital morphologic variations of vertebral artery but also evaluates the reduced blood flow of posterior circulation(i. e. posterior circulation ischemia), which might become one of the hallmarks of VAH.