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伴有椎动脉优势的后循环梗死的血流动力学研究
朱伟王亚芳冯红选董晓峰
0
()
摘要:
目的 观察伴有椎动脉优势(VAD)的后循环梗死患者的血流动力学变化。方法 将临床 表现为后循环梗死、头晕和眩晕、头痛等症状共156 例患者,根据头颅MRA 椎动脉优势评判标准分为伴 VAD 组(86 例)和不伴VAD 组(70 例),通过TCD 观察每组后循环供血动脉的血流动力学变化。结果 伴 VAD 组优势侧椎动脉Vs、Vd、Vm值高于非优势侧,也高于不伴VAD 组(P < 0.05)。伴VAD 组基底动 脉Vd 和Vm 值低于不伴VAD 组(P < 0.05),PI 和RI 高于不伴VAD 组(P< 0.05)。两组大脑后动脉的Vs、 Vd、Vm、PI、RI 值比较差异均无统计学意义(P> 0.05),伴VAD 组出现频谱形态异常。结论 伴VAD 患 者出现脑血流动力学改变,优势侧椎动脉血流速度增快,基底动脉血流速度减慢,可能是造成后循环梗 死的原因之一。
关键词:  后循环梗死  椎动脉优势  血流动力学
DOI:10.3969/j.issn.1009-6574.2018.06.010
基金项目:苏州市科技发展计划项目(SYSD2016114)
Hemodynamic study of posterior circulation infarction with vertebral artery dominance
()
Abstract:
Objective To observed hemodynamic changes in the posterior circulation infarction patients with vertebral artery dominance( VAD). Methods According to magnetic resonance angiography (MRA) and the diagnostic criteria of VAD, 156 patients with posterior circulation infarction( PCI), dizziness and headache were divided into VAD group( n=86) and non-VAD group( n=70). All enrolled subjects were performed transcranial Doppler ultrasound( TCD) examination. Results The values of systolic velocity( Vs), mean velocity (Vm) and diastolic velocity( Vd) in the dominant VA of VAD group were higher than those in the non-dominant VA of VAD group and bilateral VA of non-VAD group( P<0.05). Compared with bosic artery of two groups,the level of Vd and Vm in the VAD group were less than those in the non-VAD group( P<0.05), and the level of pulsatility index( PI) and resistance index( RI) were higher than those in the non-VAD group( P<0.05). There were no significant difference in Vs、Vd、Vm、PI and RI of posterior cerebral artery( PCA) in two groups( P> 0.05). Conclusions There are cerebral hemodynamic changes in VAD patients. The blood flow velocity of the dominant VA is faster than that of non-dominant VA, which may be due to posterior circulation infarction.
Key words:  Posterior circulation infarction  Vertebral artery dominance  Hemodynamics

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