锁骨下动脉盗血综合征经颅多普勒超声分析

目的 分析锁骨下动脉盗血综合征(SSS)与锁骨下动脉(SUBA)狭窄程度、同侧椎动脉(VA)盗血程度的相关性及盗血途径.方法 回顾分析应用经颅多普勒超声诊断的SSS患者37例临床资料,依据血流速度将SUBA狭窄分为轻中度、重度及闭塞3种情况,依据椎动脉血流方向将盗血程度分为Ⅰ期、Ⅱ期、Ⅲ期.比较SUBA不同狭窄程度与盗血程度的相关性.结果 SBUA轻中度狭窄15例,无盗血及Ⅰ期盗血12例(80%);重度狭窄14例,无盗血及Ⅰ期盗血3例(21%);二者比较差异有统计学意义(P＜0.05).轻中度狭窄组Ⅱ期及Ⅲ期盗血3例(20%),重度狭窄组Ⅱ期及Ⅲ期盗血11例(78%),二者比较差异有统计学意义(P＜0.05).重度狭窄组Ⅲ期盗血2例(14%),闭塞组Ⅲ期盗血7例(87%),二者比较差异有统计学意义(P＜0.05).双侧SUBA狭窄10例,其中双侧盗血1例.4例同时行数字减影血管造影术检查,结果与经颅多普勒超声检查结果完全相符;5例同时行CT血管造影术检查,其中3例与经颅多普勒超声检查结果相符,2例未见异常.盗血途径:椎动脉(VA)-VA28例(75.6%),基底动脉(BA)-VA 9例(24.4%).结论 经颅多普勒超声可早期发现SUBA狭窄,间接判断狭窄程度、盗血程度、盗血途径,可早期指导治疗.SUBA狭窄程度与盗血程度成正相关,VA-VA为常见盗血途径.

Analysis of subclavian steal syndrome by transcrinial Doppler ultrasound

Objective To analyse subclavian steal syndrome(SSS)by transcrinial Doppler ultrasound (TCD)and to explore the rdationship between the different degrees of subelavian artery(SUBA)and the degree of steal blood vertebral artery and clinieal value of TCD.Methods Thirty seven patients of SSS were divided into three groups according to vdoeity of SUBA and direction of vertebral artery.The stenosis of SUBA and steal degree were compared.Results Mild and moderate stenosis of SUBA were found in 15 cases with no steal and stage Ⅰ steal in 12 cases(80%);Severe stenosis of SIJBA was found in 14 cases with no steal and stage Ⅰ steal in 3 cases(21%),with significant difference between the two groups(P＜0.05).In mild and moderate stenosis group,there were 3 cases of stage Ⅱ and Ⅲ steal(20%)while in severe stenosis group there were 11 cases of stage Ⅱ and Ⅲ steal (78%),among which,the signifieant difference(P＜0.05)was observed.Stage Ⅲ steal was found in 2 cases of severe stenosis group(14%)and 7 cases of occlusion group(87%),with significant difference(P＜0.05).10 cases were found to have bilateral SUBA stenoeis,including 1 case of bilateral steal.4 cases underwent digital subtraction angiography(DSA)which results were in accordance with the results of TCD.5 cases underwent CT angiography,the results of 3 of which were similar with TCD but 2 cases did not show any abnormality.Steal happened from vertebral artery(VA)-VA in 28 cases(75.6%)and basal artery(BA)-VA in 9 cases(24.4%).Conclusion TCD could be used to diagnose SSS and the degree of steal blood.The degreo of SUBA stenosis is related to degree of vertwbral artery steal.