应用血管超声分析椎动脉管径发育不良与眩晕的关系

目的探讨椎动脉管径发育不良与眩晕的关系。方法选择一侧椎动脉管径发育不良的患者288例，按是否存在眩晕分为眩晕组（201例）和非眩晕组（87例）。应用彩色多普勒血流显像（CDFI）和经颅多普勒超声（TCD），分析椎动脉管径发育不良与眩晕的关系。结果①椎动脉发育不良患者眩晕发生率为69．8％（201／288）。其中椎动脉管径≤2．0mm者61例，有83．6％（51／61）的患者发生眩晕；2．0mm〈管径≤2．5mm者227例，有66．1％（150／227）的患者发生眩晕，P=0．008。②眩晕组、非眩晕组患侧椎动脉管径分别为（2．18±0．21）、（2．27±0．17）mm；健侧为（3．54±0．46）、（3．03±0．27）mm。两组比较，均P〈0．01。③眩晕组患侧椎动脉椎间隙段、颅内段收缩期峰值流速为（51±10）、（49±9）cm／s；非眩晕组为（54±11）、（52±10）cm／s，两组比较，均P〈0．05。眩晕组患侧颅内段的收缩期峰值流速明显低于椎间隙段（P〈0．05），而非眩晕组差异无统计学意义。④椎动脉管径发育不良患者中，21～39岁、40～59岁、60～81岁眩晕发生率分别为47．6％、67．2％、80．5％，x^2=10．157，P〈0．01。结论眩晕与椎动脉管径发育不良密切相关。椎动脉管径纤细引起的血流动力学改变是造成眩晕的重要原因之一。

Analysis of the relationship between vertebral artery hypoplasia and vertigo with vascular ultrasonography

Objective To investigate the relationship between vertebral artery hypoplasia and the occurrence of vertigo. Methods A total of 288 patients with unilateral vertebral artery hypoplasia （ hypoplasia group） were recruited. They were divided into either a vertigo group （ n = 201 ） or a non-vertigo group （n = 87 ）. Color Doppler flow image （CDFI） and transcranial Doppler （TCD） were used to analyze the relationship between vertebral artery hypoplasia and vertigo. Results （1）The overall incidence of vertigo in patients with vertebral artery hypoplasia was 69.8% （201/288） among them, the vertebral artery diameter ≤2.0 mm in 61 patients, the incidence of vertigo was 83.6% （51/61） ; the vertebral artery diameter 2.0 - 2.5 mm in 227 patients, the incidence of vertigo was 66.1% （ 150/227 ） （ P = 0. 008 ）. （2）The ipsilateral vertebral artery diameters in the vertigo and non-vertigo groups were 2.18 -± 0.21 mm and 2.27 ±0.17 mm, respectively, and the contralateral vertebral artery diameters were 3.54 ±0.46 mm and 3.03 ±0.27 mm, respectively. P 〈0.01 all. The peak systolic velocity at the intervertebral segment and intracranial segment of ipsilateral vertebral artery in the vertigo group were 51 ± 10 cm/s and 49 ± 9 cm/s, respectively, and in the non-vertigo group were 54 ± 11cm/s and 52 - 10 cm/s, respectively. There was a statistical difference between the two groups （P 〈0.05 all）. The peak systolic velocity at the ipsilateral intracranial segment in the vertigo group was significantly lower than that at the intervertebral segment （P 〈 0. 05 ） , and there was no significant difference in the non-vertigo group. Among the patients with vertebral artery hypoplasia, the incidences of vertigo were 47.6% , 67.2% , and 80.5% respectively in patients aged 21 -39 years, 40 -59 years, and 60 -81 years （X^2 = 10. 157, P 〈0.01 ）. Conclusion Vertigo is closely related to vertebral artery hypoplasia. The hemodynamic change cause by the thin diameter of vertebral artery is the important reason for vertigo.