摘要
目的:应用经颅多普勒(transcranialDoppler,TCD)对颈性眩晕患者血流动力学进行分型,寻找各型血流动力学差异的依据。方法:2003-11/2004-07武汉大学中南医院诊断为颈性眩晕的住院患者91例,采用TCD检测其血流动力学。所有患者进行血压、眼底镜、血脂、血糖、血流变学、颈椎X射线、MRI及磁共振血管造影(magneticresonanceangiography,MRA检查。)结果:颈性眩晕血流动力学可分为4型:高流型(27%)、正流型(22%)、低流型(48%)、血流信号消失型(2%)。高流型存在的依据为较严重的颈椎生理弯曲异常、椎间失稳、寰椎椎动脉沟环、局部横突孔狭窄和椎间盘突出等;正流型示颈椎及椎基底动脉轻度异常;低流型存在的依据为椎基底动脉硬化、高脂血症、高黏血症、颈椎间隙变窄、钩椎关节增生等;血流信号消失型与椎动脉缺如或闭塞有关。结论:颈性眩晕血流动力学TCD分型,有利于理解颈性眩晕发病机制、推测病因及指导临床治疗实践,但尚应结合眼底镜检查、血黏度、血脂及影像学结果来制定更合理的治疗方案。
AIM: To investigate the hemodynamic types of cervical vertigo (CV) patients wi th transcranial Dopper(TCD), and find the evidence of hemodynamic difference. METHODS:A total of 91 hospitalized patients were diagnosed as CV in China Sout h Hospital from November 2003 to July 2004, and the hemodynamics was examined by TCD.All patients accepted the examinations, including blood pressure, ophthalmo scope, blood lipids,blood glucose, hemorheology, cervical X ray, MRI and magnet ic resonance angiography (MRA). RESULTS:Hemodynamics of CV could be divided into 4 types: high velocity type ( 27%), normal velocity type(22%),low velocity type (48%) and blood flow signal absence(2%).The existent evidences of high velocity type were the severer phys iological curve of abnormal cervical vertebra, intervertebral instability, verte bral artery sulcus ring of atlas, part transverse foramen stenosis,intervertebra l disc herniation, etc. Mild abnormality of cervical vertebral and vertebro basi lar artery existed in normal velocity type. The existent evidences of low veloci ty type were vertebro basilar arteriosclerosis, hyperlipidemia, hyperviscosity, the narrowing of cervical intervertebral space, luschka hyperplasia, etc. And bl ood flow signal absence was related to vertebral artery absence or occlusion. CONCLUSION: The hemodynamic typing of TCD in CV can be convenient for understa nding the pathogenesis of CV, predicting the pathogeny and guiding the clinical therapeutic practice. But the more reasonable therapy should be established acco rding to the examinations of ophthalmoscope, blood viscosity, blood lipids and i maging.
出处
《中国临床康复》
CSCD
北大核心
2005年第1期64-65,共2页
Chinese Journal of Clinical Rehabilitation
