椎动脉供血与颈性眩晕的相关性研究.docVIP

精品论文 参考文献 椎动脉供血与颈性眩晕的相关性研究 陈　栋　李中实　石东平　蒋　欣　赵景鑫 　　卫生部中日友好医院　北京　１０００２９ 　　【摘要】　目的　探讨颈性眩晕发病与椎动脉供血区脑血流量的变化及其发病机制.方法　颈性眩晕患者９３例,年龄２６~８０岁,平均５４．５岁.病程１周~３０年,平均４６．２个月.由颈椎运动负荷试验诱使颈性眩晕患者其发病,同时使用近红外光谱仪动态观察患者左右两侧椎动脉供血区脑血流量的变化及其诱发症状情况.结果　９３例患者中,被颈椎运动负荷试验诱发颈性眩晕发病者８５例,阳性率为９１％;近红外光谱仪检测椎动脉供血区脑血流量异常改变者８２例,阳性率为８８．２％.左右两侧椎动脉供血区脑血流变化的阳性率分别为６９．９％和７６．３％,两者间无统计学差异.结论　颈性眩晕发病与椎动脉供血区脑血流量变化有关,左、右两侧椎动脉在颈性眩晕发病上权重相当.颈椎运动负荷试验和近红外光谱仪检查有助于颈性眩晕的诊断及鉴别诊断. 【关键词】　颈性眩晕,发病机制,近红外光谱仪,交感神经,椎动脉【Abstract】objective　Tostudytherelationbetweenthechangesofcerebralbloodflowandcervicalvertigo,andresearchthepathogenesisofcervicalvertigo． Methods　９３patientswithaverageageof５４．５year－oldwererandomlyselectedfromthepatientsofvertigo,whowerediagnosedofcervicalvertigobyanalysisoftheirmedicalrecord,examinationandtheeliminationoftheothertypesofvertigo．Thenthepatientisaskedtotakethecervicalmotionloadtest．Atthesametime,thepatient??sinducedsymptoms,theNIRScurveanditsdatachangesaredynamicallyobserved．Results　８５patientsareinducedtosymptomswithincidenceof９１％．NIRSchangesarefoundin８２patientsof９３withadiseaseincidenceof８８．２％．Among８２cervicalvertigopatientswhohavetheNIRSchanges,６５arefoundwithchangesinthebloodsupplyingareaofleftvertebralartery(６９．９％),and７１arefoundwithchangesinthebloodsupplyingareaofrightvertebralartery(７６．３％)．Thereisnoobviousdifference(p＞０．０５)betweentheleftandtherightside．Conclusion　Cervicalvertigoisrelatedtothedysfunctionofvertebralartery,．Thereisnoobviousdifferencebetweentheleftandtherightareassuppliedbyvertebralarteryinpathogenesisofcervicalvertigo．Thecervicalmotionloadtestcombi【nKeedywwiotrhdsN】I:RSisvaluableforthediagnosisofcervicalvertigo． CervicalVertigo;Pathogenesis;Nearinfraredspectroscopy;Nervussympatheticus;Vertebralartery 【中图分类号】R６８１．５ 【文献标识码】B 　　【文章编号】１００８－６３１５(２０１５)１２－１０８８－０２　　 　　颈性眩晕(cervicalvertigo)是指由颈椎疾病引起的、以眩晕及交感神经症状为主的症候群.其发病机制不清楚,有脑供血不足、交感神经源性及颈髓损伤等学说,其中脑供血不足与颈性眩晕发病的关系引人嘱目[１,２,１７,２７].但颈性眩晕是否为脑缺血所致、脑的哪一部分组织缺血、是颈动脉还是椎动脉或哪一侧的椎动脉缺血、脑缺血与本病出现的复杂症状究竟有无因果关系等问题均属未知.本研究应用颈椎运动负荷试验[３]诱使颈性眩晕患者发病,并通过近红外光谱仪(near－infrared