CAJ | 학술논문

目的探讨颈总动脉(CCA)闭塞的老年患者颈动脉血流动力学特点及彩色多普勒超声诊断价值. 方法选取30例COA闭塞或重度狭窄(狭窄率＞70％)患者为病例组;30例颈动脉超声各项指标正常者作为对照组,测量CCA颈内动脉(ICA)、颈外动脉(ECA)及椎动脉(VA)的峰值血流速(PSV)舒张末期血流速(EDV)、平均血流速度(MV)、阻力指数(RI). 结果病例组患侧的ICA的PSV低于对照组(P＜0.01),EDV、MV均低于对照组(P＜0.05);患侧ECA是逆向血流或双向血流;健侧ECA的PSV、EDV、MV均高于对照组(均P＜0.01).病例组双侧VA血速与对照组也存在显著差异,双侧VA的PSV、EDV、MV血流速高于对照组(均P＜0.01);RI也与对照组有差别(均P＜0.05). 结论 CCA闭塞后ICA的压力下降,ECA通过侧支循环后逆灌注ICA,而双侧VA血流速明显增快及对侧ECA血流速增快都是通过侧支循环途径增加血流量以代偿大脑血供.
목적 탐토경총동맥(CCA)폐새적노년환자경동맥혈류동역학특점급채색다보륵초성진단개치. 방법 선취30례COA폐새혹중도협착(협착솔＞70％)환자위병례조;30례경동맥초성각항지표정상자작위대조조,측량CCA경내동맥(ICA)、경외동맥(ECA)급추동맥(VA)적봉치혈류속(PSV)서장말기혈류속(EDV)、평균혈류속도(MV)、조력지수(RI). 결과 병례조환측적ICA적PSV저우대조조(P＜0.01),EDV、MV균저우대조조(P＜0.05);환측ECA시역향혈류혹쌍향혈류;건측ECA적PSV、EDV、MV균고우대조조(균P＜0.01).병례조쌍측VA혈속여대조조야존재현저차이,쌍측VA적PSV、EDV、MV혈류속고우대조조(균P＜0.01);RI야여대조조유차별(균P＜0.05). 결론 CCA폐새후ICA적압력하강,ECA통과측지순배후역관주ICA,이쌍측VA혈류속명현증쾌급대측ECA혈류속증쾌도시통과측지순배도경증가혈류량이대상대뇌혈공.
Objective To demonstrate the carotid artery hemodynamic characteristics in patients with common carotid artery occlusion,and to investigate the value of color Doppler ultrasonography in evaluating it.Methods 30 patients with common carotid artery (CCA) occlusion or severe stenosis (stenosis rate＞70％) were as the patients group,while 30 volunteers with the normal indicators of carotid artery ultrasonography as the control group.In both groups,the examinations of the CCA,the internal carotid artery (ICA),the external carotid artery (ECA) and the vertebral artery (VA) were taken by color Doppler ultrasonography under quiescent conditions.Bilateral carotid ultrasonography studies were performed,which included the peak systolic velocity (PSV),end-diastolic velocity (EDV),mean velocity (MV),and resistance index (RI).Results The peak systolic velocity (PSV),EDV and MV of ICA were obviously lower in case group at affected side than in the control group (P＜0.05 or 0.01).The blood flow of ECA at the affected side was retrograde or bidirectional.PSV,EDV and MV of the external carotid artery (ECA) were obviously higher in the healthy side in patients than in the control group (all P＜0.01).There was a significant difference in blood flow velocity of bilateral vertebral artery (VA) between the patients group and the control group,and the PSV,EDV and MV were obviously higher in the former than in the latter (all P＜0.01).And the RI was different between the two groups (P＜0.05).Conclusions The pressure of ICA is dropped after the common carotid artery occlusion,and then ECA reversely feeds ICA by collateral circulation.The blood flow velocities of bilateral vertebral artery and contralateral ECA are significantly increased to compensate for cerebral blood supply through collateral circulation channels.Color Doppler ultrasonography can reflect this phenomenon more fully and accurately,and provide clinically valuable diagnostic information.