中国医药
中國醫藥
중국의약
CHINA MEDICINE
2014年
10期
1471-1474
,共4页
眩晕%经颅多普勒%脑干听觉诱发电位%后循环缺血
眩暈%經顱多普勒%腦榦聽覺誘髮電位%後循環缺血
현훈%경로다보륵%뇌간은각유발전위%후순배결혈
Vertigo%Transcranial Cerebral Doppler%Brainstem auditory evoked potential%Posterior circulation ischemia
目的 探讨经颅多普勒(TCD)联合脑干听觉诱发电位(BAEP)对老年眩晕患者的病因诊断价值.方法 选取50例临床确诊为眩晕的老年患者作为眩晕组;同期门诊就诊的48例无眩晕发作史、无神经系统定位体征,包括头痛、周围神经病、睡眠障碍等的老年患者作为对照组.眩晕组患者在发作间歇期同时进行BAEP、TCD检查.TCD颅外探测双侧锁骨下动脉(SUBA)、颈总动脉、颈内动脉、颈外动脉,颅内检测双侧大脑中动脉(MCA)、大脑前动脉(ACA)、大脑后动脉(PCA),双侧椎动脉、基底动脉,双侧眼动脉(OA)、颈内动脉虹吸段(SCA).自动记录收缩峰值血流速度(Vs)、舒张期血流速度(Vd)、平均血流速度(Vm)、脉动指数、阻力指数.BAEP测量参数:Ⅰ、Ⅲ、Ⅴ各波的波幅、峰潜伏期,Ⅰ～Ⅲ、Ⅲ～Ⅴ、Ⅰ～Ⅴ峰间潜伏期.记录所有试验数据并与对照组进行比较.结果 TCD检查结果:眩晕组TCD异常40例(80.0％);其中一侧椎动脉狭窄21例,基底动脉狭窄6例,双侧椎动脉狭窄4例,一侧椎动脉合并基底动脉狭窄2例,前循环血管狭窄致基底动脉代偿1例,一侧椎动脉发育不良6例.对照组,异常12例(25.0％);其中一侧椎动脉狭窄7例,基底动脉狭窄2例,一侧椎动脉合并基底动脉狭窄2例,一侧椎动脉发育不良1例.BAEP检查结果眩晕组异常患者为42例(84.0％),主要表现为Ⅴ波峰潜伏期延长及Ⅲ～Ⅴ波峰间潜伏期延长;其中脑干型为25例、内耳型8例、混合型9例.对照组BAEP异常18例,占37.5％,主要表现为Ⅰ波及Ⅲ波峰潜伏期延长;其中脑干型为2例、内耳型10例、混合型6例.2组间患者检查异常率差异有统计学意义(P＜0.05).结论 BAEP联合TCD检测有利于老年眩晕患者的病因诊断,有利于后循环缺血的诊断.
目的 探討經顱多普勒(TCD)聯閤腦榦聽覺誘髮電位(BAEP)對老年眩暈患者的病因診斷價值.方法 選取50例臨床確診為眩暈的老年患者作為眩暈組;同期門診就診的48例無眩暈髮作史、無神經繫統定位體徵,包括頭痛、週圍神經病、睡眠障礙等的老年患者作為對照組.眩暈組患者在髮作間歇期同時進行BAEP、TCD檢查.TCD顱外探測雙側鎖骨下動脈(SUBA)、頸總動脈、頸內動脈、頸外動脈,顱內檢測雙側大腦中動脈(MCA)、大腦前動脈(ACA)、大腦後動脈(PCA),雙側椎動脈、基底動脈,雙側眼動脈(OA)、頸內動脈虹吸段(SCA).自動記錄收縮峰值血流速度(Vs)、舒張期血流速度(Vd)、平均血流速度(Vm)、脈動指數、阻力指數.BAEP測量參數:Ⅰ、Ⅲ、Ⅴ各波的波幅、峰潛伏期,Ⅰ～Ⅲ、Ⅲ～Ⅴ、Ⅰ～Ⅴ峰間潛伏期.記錄所有試驗數據併與對照組進行比較.結果 TCD檢查結果:眩暈組TCD異常40例(80.0％);其中一側椎動脈狹窄21例,基底動脈狹窄6例,雙側椎動脈狹窄4例,一側椎動脈閤併基底動脈狹窄2例,前循環血管狹窄緻基底動脈代償1例,一側椎動脈髮育不良6例.對照組,異常12例(25.0％);其中一側椎動脈狹窄7例,基底動脈狹窄2例,一側椎動脈閤併基底動脈狹窄2例,一側椎動脈髮育不良1例.BAEP檢查結果眩暈組異常患者為42例(84.0％),主要錶現為Ⅴ波峰潛伏期延長及Ⅲ～Ⅴ波峰間潛伏期延長;其中腦榦型為25例、內耳型8例、混閤型9例.對照組BAEP異常18例,佔37.5％,主要錶現為Ⅰ波及Ⅲ波峰潛伏期延長;其中腦榦型為2例、內耳型10例、混閤型6例.2組間患者檢查異常率差異有統計學意義(P＜0.05).結論 BAEP聯閤TCD檢測有利于老年眩暈患者的病因診斷,有利于後循環缺血的診斷.
목적 탐토경로다보륵(TCD)연합뇌간은각유발전위(BAEP)대노년현훈환자적병인진단개치.방법 선취50례림상학진위현훈적노년환자작위현훈조;동기문진취진적48례무현훈발작사、무신경계통정위체정,포괄두통、주위신경병、수면장애등적노년환자작위대조조.현훈조환자재발작간헐기동시진행BAEP、TCD검사.TCD로외탐측쌍측쇄골하동맥(SUBA)、경총동맥、경내동맥、경외동맥,로내검측쌍측대뇌중동맥(MCA)、대뇌전동맥(ACA)、대뇌후동맥(PCA),쌍측추동맥、기저동맥,쌍측안동맥(OA)、경내동맥홍흡단(SCA).자동기록수축봉치혈류속도(Vs)、서장기혈류속도(Vd)、평균혈류속도(Vm)、맥동지수、조력지수.BAEP측량삼수:Ⅰ、Ⅲ、Ⅴ각파적파폭、봉잠복기,Ⅰ～Ⅲ、Ⅲ～Ⅴ、Ⅰ～Ⅴ봉간잠복기.기록소유시험수거병여대조조진행비교.결과 TCD검사결과:현훈조TCD이상40례(80.0％);기중일측추동맥협착21례,기저동맥협착6례,쌍측추동맥협착4례,일측추동맥합병기저동맥협착2례,전순배혈관협착치기저동맥대상1례,일측추동맥발육불량6례.대조조,이상12례(25.0％);기중일측추동맥협착7례,기저동맥협착2례,일측추동맥합병기저동맥협착2례,일측추동맥발육불량1례.BAEP검사결과현훈조이상환자위42례(84.0％),주요표현위Ⅴ파봉잠복기연장급Ⅲ～Ⅴ파봉간잠복기연장;기중뇌간형위25례、내이형8례、혼합형9례.대조조BAEP이상18례,점37.5％,주요표현위Ⅰ파급Ⅲ파봉잠복기연장;기중뇌간형위2례、내이형10례、혼합형6례.2조간환자검사이상솔차이유통계학의의(P＜0.05).결론 BAEP연합TCD검측유리우노년현훈환자적병인진단,유리우후순배결혈적진단.
Objective To inverstigate the etiological diagnosis value of transcranial cerebral doppler (TCD) and brainstem auditory evoked potential(BAEP) in the elderly vertigo suffers.Methods Totally 50 cases of elderly patients with clinical diagnosis of vertigo as vertigo group were enrolled ; there were 48 cases elderly patients without history of vertigo,neurological signs including headache,peripheral neuropathy and sleep disorders.The extracranial arteries including both sides of common carotid artery,internal carotid artery,external carotid artery and subclavian artery(SUBA) were detected by TCD; the date of Vm,Vs,Vd,pulse index,resistance index were recorded.The data of BAEP including the altitude and peak latency of wave Ⅰ,Ⅲ,Ⅴ and the interpeak latency of wave Ⅰ-Ⅲ,Ⅲ-Ⅴ,Ⅰ-Ⅴ was recorded.Results The abnormal rate of TCD and BAEP was 80.0％(40/50) and 84.0％ (42/50) in the vertigo group ; the abnormal rate of TCD and BAEP was 25.0％ (12/48) and 37.5％ (18/48) in the control group.There were 21 patients with one vertebral artery(VA) stenosis,6 patients with basilar artery(BA) stenosis,4 patients with both sides VA stenosis,2 patients with 1 VA and BA stenosis,1 patient with anterior circulation artery stenosis and BA compensation.There were 7 patients with 1 VA stenosis,2 patients with BA stenosis,2 patients with 1 VA and BA stenosis,1 patient with 1 vertebral artery hypoplasia in the control group.The abnormalty of BAEP mainly showed the prolonging peak latency of wave V and the prolonging of interpeak latency of wave Ⅲ-Ⅴ.There were 25 patients with brain stem type,8 patients with 1 nner-ear type,9 patients with mixed type in the vertigo group.There were 2 patients with nrain stem type,10 patients with inner-ear type and 3 patients with mixed type.The difference between two groups was statistical significant (P ＜0.05).Conclusion The joint inspection of TCD and BAEP helps the etiological diagnosis of elderly vertigo suffers including posterior circulation ischemia.
