交感型颈椎病伴单侧椎动脉狭窄患者头颈部活动后椎动脉血流的观察

目的 :探索交感型颈椎病伴单侧椎动脉狭窄患者头颈部活动后椎动脉血流变化及其与眩晕发作的关系。方法 :选择 2 0 7例临床确诊为交感型颈椎病患者 ,筛选出伴单侧椎动脉内径小于 2 mm的 2 5例患者为狭窄组 ,其余的 182例患者为非狭窄组。 3 0例正常人为对照组。通过头颈部活动诱发眩晕 ,在诱发运动前及运动后即刻用彩色多普勒对双侧椎动脉走行、管腔结构、内径、血流速度 (PV)和阻力指数 (RI)进行测定 ,并作详细记录。比较狭窄组与非狭窄组及对照组上述指标的变化。结果 :1.头颈部活动前三组间椎动脉血流速度有统计学差异 (69.1± 2 .9) cm/ s vs(42± 8.4) cm/ s vs(50± 8.2 ) cm/ s,P<0 .0 5] ,活动后狭窄组与非狭窄组血流速度没有统计学差异 (P>0 .0 5) ,但与对照组比较 ,有显著性差异 ;2 .头颈部活动后 ,椎动脉血流变化的人数及血管变化条数 ,狭窄组多于非狭窄组和对照组 ,分别为 (2 5/ 2 5vs13 4 / 182 vs19/ 3 0 ,P<0 .0 5)及 (3 6/ 50vs185/ 3 64vs2 3 / 60 ,P<0 .0 5) ;3 .头颈部活动后引起眩晕的人数 ,狭窄组明显多于非狭窄组 (19/ 2 5vs83 / 182 ,P<0 .0 5)。狭窄组狭窄侧椎动脉内径与对侧椎动脉内径及非狭窄组和对照组椎动脉内径比较有统计学差异 (P<0 .0 1)。狭窄组头颈部活动后椎动脉血流

Study on Variety of Vertebral Artery Flow Velocity Before and After Head Movement in Sympathetic Cervical Spondylosis Patients with Unilateral Vertebral Artery Stenosis

Objective:To study the relationship of the changes of verteb ral artery hemodynamics after head movement and the unilateral vertebral artery stenosis to the onset of vertigo in sympathetic cervical spondylosis patients.Methods:Using color Doppler ultrasonography,the morphology an d hemodynamics of vertebral arteries in 207 patients with sympathetic cervical s pondylosis and 30 healthy subjects (control group) were evaluated before and aft er head movement Two hundred and seven patients were divided into unilateral ve rtebral artery stenosis group (stenosis group,25 cases) and without stenosi s group(non-stenosis group,182 cases) The results of the three groups were comp ared mutually.Results:1 Before head movement,there were statistical differe nces in vertebral arterial flow velocities among the three groups(P<0 05) After head movement,there were no differences in the arterial flow velocities between the stenosis group and the non-stenosis group,but the velocity in the se two groups were higher than that in the control group 2 After head movemen t,the number of patients with changes in vertebral arterial flow velocities in t he stenosis group was more than that in the non-stenosis group and the contro l group(P<0 05) 3 After head movement,the number of patients with vertig o attacks in the stenosis group was more than that in non-stenosis group(P <0 05) The inner diameters of the vertebral ateries on the stenotic side in the stenosis group were smaller than those of the normal side in their own grou p and those in the nons-stenosis group (P<0 01) After head movement,t he re were increase or decrease in vertebral arterial flow velocities in the stenos is group,while no changes of the non-stenosis group Conclusions:1 Head movement may more easily cause vertebral art ery flow changes in sympathetic cervical spondylosis patients with unilateral vertebral artery stenosis than patients without stenosis in the vertebral artery ,so it is easy to cause vertigo attack;2 Dysfunction to regulate the pressure balance in the vertebral artery is one main reason to cause the onset of vertig o in sympathetic cervical spondylosis