椎动脉型颈椎病患者椎-基底动脉血供的TCD探讨

目的探讨椎动脉型颈椎病(CSA)患者椎．基底动脉血供异常的经颅多普勒超声(TCD)表现形式。方法采集100例具有分析价值的CSA患者TCD检浸4结果，分析收缩峰期血流速度(Vp)、舒张末期血流速度(Vd)、平均血流速度(Vm)等指标检测值的状态，并与文献资料对比。结果受检患者TCD异常率为87％，其中3支血管均异常者占17．2％，2支异常者占32．2％，1支异常者占50．6％；既有VA又有BA异常者占17．2％，仅有VA异常者占49．4％，仅有BA异常者占33．3％。盯例异常患者涉及异常血管数占全部受检血管的65．9％，其中低流速血管占66．9％。高流速血管占33．1％；有16．1％的患者一侧VA流速降低，而另一侧流速增高。结论CSA患者椎．基底动脉血流异常，既有低流速状态，又有高流速状态，而以低流速状态多见；部分患者尚有VA供血失衡的现象，反映出CSA患者椎．基底动脉血流动力学处于紊乱状态。

Vertebral-Basilar Blood Dynamics of the Patients of Cervical Spondylosis of Arterial Type

Objective To observe the Transcranial Doppler(TCD)man ifestations of vertebral-basilar blood s upply in the patients of cervical spondy losis of arterial type(CSA).Methods TCD testing results of 100 CSA cases were collected.Indexes such as Vp(velocity of spicke systole ph ase),Vd(velocity of late diastolic phase )and Vm(mean velocity)were analyzed,whos e result were compared later with other literiture.Results 87% of all the 100 c ases were detected abnormal on blood dyn amics,among them,cases with 3 or 2 or 1 abnormal vessels counted respectively 17 .2%,32.2%,and 50.6%;cases with abnormal Vertebral Artery(VA)and Basilar Artery(B A),only abnormal VA,or only abnormal BA counted respectively 17.2%,49.4% and 33. 3%.Besides,65.9% of all the detected ves sels in the 87 patients were found abnor mal,among them,66.9% showed low velocity ,while 33.1% showed high velocity;16.1% of the cases showed low velocity of VA o n one side and high on the other side.Conclusion The abnormality o f V-B velocity varies from low to high c onditions in CSA patients,but more as lo w velosity;some of the patients showed i nbalanced VA blood supply,which indicate s a disorder of V-B blood dynamics in CS A patients. [Key words] cervical spondyl osis;vertebral-basilar artery;velocity;u ltrasonic examination;transcranial doppl er