锁骨下动脉盗血综合征椎基底动脉供血不足与盗血程度及类型的相关性分析

目的 探讨锁骨下动脉盗血综合征椎基底动脉供血不足与盗血程度及类型的关系.方法 对80例行经颅多普勒超声诊断为锁骨下动脉盗血综合征患者回顾分析,其中24例进一步行数字减影动脉血管造影（DSA）.以同侧椎动脉血流方向判定盗血程度,以基底动脉是否参与盗血为类型,对椎基底动脉供血不足与盗血程度及盗血类型进行相关性分析.结果 24例进一步行DSA检查者锁骨下动脉起始部狭窄严重程度同TCD检查同侧椎动脉盗血程度成正比（t=15.59,P＜0.05）.椎基底动脉供血不足症状与盗血程度无关（P＞0.05）.基底动脉参与盗血的患者中有21例（77.8％）存在椎基底动脉供血不足,未参与盗血的患者中有18例（33.9％）,两者比较差异有统计学意义（P＜0.05）.结论 由锁骨下动脉盗血综合征引起的椎基底动脉供血不足与同侧椎动脉盗血程度无关,与基底动脉是否参与盗血密切相关,关注基底动脉是否参与盗血有利于分析患者病情并指导临床治疗.

Correlation analysis of vertebrobasilar insufficiency caused by subclavian steal syndrome and degree or type of steal phenomena

Objective To explore the relationship between vertebrobasilar insufficiencies caused by subclavian steal syndrome and degree or type of steal phenomena.Methods 80 patients who were diagnosed subclavian steal syndrome by transcranial doppler ultrasound were analyzed retrospectively,24 cases in them were received digital subtraction angiography.The degree of steal phenomena were determined by direction of blood flow in the ipsilateral vertebral artery,and the type of steal phenomena were determined by whether basilar artery involved in steal phenomena.Finally,we made the correlation analysis between vertebrobasilar insufficiency caused by subclavian steal syndrome and degree or type of steal phenomena.Results There was a significant relationship between the severity of subclavian artery stenosis and degree of VA steal in 24 patients performed with both TCD and DSA（t =15.59,P ＜0.05）.There was no significant relationship between the vertebrobasilar insufficiency and severity of steal phenomena （P ＞0.05）.There were 21cases（77.8％） exist vertebrobasilar insufficiency in the patients whose basilar artery were involved in steal phenomena,and there were 18 cases（33.9％） exist ertebrobasilar insufficiency in the patients whose basilar artery were not involved in steal phenomena.There was a significant differences between the two type of steal phenomena（P ＜ 0.05）.Conclusion The vertebrobasilar insufficiency caused by subclavian steal syndrome doesn＇t associate with the degree of steal phenomena,and associates with the type of steal phenomena.Paying close attention to whether basilar arteries are involved in steal phenomena is useful for analyzing the patient ＇s condition and guide clinical treatment.