单侧椎动脉先天性发育不良超声检测参数与眩晕关系的分析

摘要

Objective To investigate the relationship between unilateral vertebral artery hypoplasia and the occurrence of vertigo.Methods A total of 309 patients with unilateral vertebral artery hypoplasia were recruited.Patients were divided into physiological fine group(2.0 mm＜Diameter≤2.5 mm)(n=208)and physiological narrow group(Diameter≤ 2.0 mm)(n =101)according to different degrees of narrowing.Meanwhile,in accordance with the existence of the symptoms of vertigo,patients were also divided into vertigo group(n=186)and non-vertigo group (n=123).Two-dimensional image and doppler ultrasound were used to study the diameters and blood flow images of vertebral arteries in those cases.Results (1)The overall incidence of vertigo in patients with unilateral vertebral artery hypoplasia was 60.19％(186/309).Among them,the incidence of vertigo was 50.48％ in physiological fine group (105/208);the incidence of vertigo was 80.20％ in physiological narrow group(81/101)(P＜0.01).(2)The diameters and the peak systolic velocities (PSV) at the ipsilateral intervertebral segment in physiological fine group were significantly less than those in physiological narrow group and resistance index (RI) was higher in physiological narrow group.All have a statistical difference between two groups(P＜0.001).(3) The diameters,PSV and the end diastolic velocities at the contralateral intervertebral segment in the non-vertigo group were significantly larger than those in the vertigo group.All have statistical difference between two groups(P＜0.01).Conclusions There is a close relation ship between unilateral vertebral artery hypoplasia and vertigo.When a vertebral artery becomes narrow to a certain extent and the contralateral one does not have good compensation,the symptoms of vertigo tend to occur.Unilateral vertebral artery hypoplasia may become an independent factor of the symptoms of vertigo.%目的 探讨单侧椎动脉先天性发育不良超声检测参数与眩晕的关系.方法 对单侧椎动脉先天性发育不良的309个病例,按照椎动脉发育不良的程度分为生理性全程细组(2.0 mm＜管径≤2.5mm)(208例)和生理性全程狭窄组(管径≤2.0 mm)(101例),按是否存在眩晕的症状分为眩晕组(186例)和非眩晕组(123例),超声检测椎动脉管径大小和血流动力学参数.结果 (1)单侧椎动脉先天性发育不良的患者眩晕发生率为60.19％ (186/309),其中生理性全程细组眩晕发生率为50.48％ (105/208),全程狭窄组眩晕发生率为80.20％ (81/101),P＜0.01.(2)生理性全程狭窄组患侧管径和椎间隙段收缩期峰值流速PSV均显著小于生理性全程细组,且阻力指数RI较大,差异均有统计学意义,P均＜0.001.(3)非眩晕组的健侧椎动脉管径、PSV、舒张末期流速EDV数值均较眩晕组大,差异有统计学意义,P均＜0.01.结论 单侧椎动脉先天性发育不良与眩晕存在密切的关系,椎动脉管径狭窄到一定程度而对侧没有良好的代偿时,往往容易发生眩晕症状.椎动脉先天性发育不良可成为眩晕的独立影响因素.