TCD在锁骨下动脉盗血综合征诊断中的临床研究

目的探讨经颅多普勒超声(TCD)对锁骨下动脉盗血综合征(SSS)的诊断价值。方法回顾性总结100例经TCD检查诊断的锁骨下动脉(Sub-A)严重狭窄或闭塞患者。用经颅多普勒超声仪检测双侧椎动脉血流速度及频谱的变化,根据同侧椎动脉(Ip-VA)TCD检测的血流方向,将盗血程度分为:无盗血(Ip-VA完全正向)、Ⅰ度盗血(Ip-VA收缩期有切迹)、Ⅱ度盗血(Ip-VA收缩期反向,舒张期正向)和Ⅲ度盗血即完全盗血(Ip-VA完全反向)。盗血途径:基底动脉参与盗血(基底动脉呈盗血频谱)或不参与盗血两种。结果经TCD检查无盗血35例,Ⅰ度盗血20例,Ⅱ度盗血15例,Ⅲ度盗血30例。结论 TCD是诊断SSS及盗血程度的可靠方法,适用于临床诊断。

The Clinical Research of TCD in Diagnosis of Subclavian Steal Syndrome

Objective To explore the diagnostic value of subclavian steal syndrome （SSS） by transcranial doppler ultrasound （TCD）. Methods Retrospectively reviewed 100 cases by TCD diagnosis of subclavian artery （Sub-A） severe stcnosis or occlusion. Using transcranial doppler ultrasound to detect the bilateral vertebral artery blood flow velocity and spectrum changings according to the direction of blood flow of the ipsilateral vertebral artery （Ip-VA） TCD detection, the steal extent is divided into： no steal （Ip-VA full forward）, stage Ⅰ （tp-VA systolic notch）, stage Ⅱ steal （Ip-VA systolic reverse diastolic forward） and stage incompletely steal （lp-VA is reverse flow completely）. The steal pathway was defined as basilar artery steal pathway （with steal waveform in basilar artery） or non-basilar artery steal pathway （normal direction in BA）. Results No steal 35 cases, stage Ⅰ 20 cases, stage Ⅱ 15 cases, stage Ⅲ 30 cases. Conclusion TCD is a reliable method of diagnosis of SSS and steal extent applicable to the clinical diagnosis.