不同类型锁骨下动脉盗血综合征的血流动力学比较

    Comparison of hemodynamics in different types of subclavian artery steal syndrome

    • 摘要:
      目的探讨不同类型锁骨下动脉盗血综合征(SSS)的临床资料和超声血流动力学差异。
      方法选取中国科学技术大学附属第一医院经超声检查发现SSS病人121例,其中Ⅰ型53例、Ⅱ型40例及Ⅲ型28例,分析病人的临床资料及血流动力学参数。
      结果Ⅰ型、Ⅱ型及Ⅲ型SSS的年龄、性别、病因、病变部位差异均无统计学意义(P>0.05);SSS病人患侧椎动脉内径、椎动脉PSV和椎动脉EDV均小于健侧(P < 0.01);3种类型SSS患侧椎动脉内径、椎动脉EDV及健侧椎动脉EDV比较差异无统计学意义(P>0.05)。Ⅲ型SSS患侧及健侧椎动脉PSV最快,Ⅰ型与Ⅱ型SSS患侧椎动脉PSV差异无统计学意义(P>0.05)。Ⅲ型SSS患侧及健侧椎动脉均RI高于Ⅰ型(P < 0.01和P < 0.05)。SSS盗血程度与患侧锁骨下动脉狭窄程度呈正相关(rs=0.527,P < 0.05)。
      结论不同类型SSS患侧及健侧椎动脉血流动力学存在差异,结合椎动脉频谱形态,能更好的判断盗血程度及锁骨下动脉狭窄程度。

       

      Abstract:
      ObjectiveTo investigate the clinical data and ultrasonic hemodynamic differences in different types of subclavian artery steal syndrome (SSS).
      MethodsA total of 121 patients with SSS detected by ultrasonography in The First Affiliated Hospital of University of Science and Technology of China were selected, including 53 patients with type Ⅰ, 40 patients with type Ⅱ and 28 patients with type Ⅲ.The clinical data and hemodynamic parameters of the patients were analyzed.
      ResultsThere was no significant difference in age, sex, etiology and lesion site of typeⅠ, type Ⅱ, and type Ⅲ SSS (P>0.05).The vertebral artery diameter, peak systolic velocity (PSV) and end diastolic velocity (EDV) on the affected side of SSS were smaller than those on the healthy side (P < 0.01).There was no statistically significant difference in the diameter of the affected vertebral artery, the EDV of the vertebral artery and the EDV of the healthy vertebral artery among the three types of SSS (P>0.05).The PSV of the affected and healthy vertebral arteries of type Ⅲ SSS was the fastest, and there was no significant difference between type Ⅰ and type Ⅱ SSS (P < 0.05).The vertebral artery RI in the affected and healthy side of type Ⅲ SSS was higher than that in type Ⅰ (P < 0.01 and P < 0.05).The degree of SSS blood steal was positively correlated with the degree of subclavian artery stenosis (rs=0.527, P < 0.05).
      ConclusionsThere are differences in hemodynamics between the affected and healthy vertebral arteries of different types of SSS.Combining with the spectral morphology of vertebral arteries, the degree of blood steal and the degree of subclavian artery stenosis can be better judged.

       

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