椎动脉扭曲与颈源性眩晕的关系_居克举.pdf

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1、·306·JClinNeurol，August2013，Vol．26，No．4·学术交流·椎动脉扭曲与颈源性眩晕的关系居克举，程冠亮，曹化，田向阳【摘要】目的探讨椎动脉扭曲与颈源性眩晕的关系。方法对31例拟诊为颈源性眩晕(眩晕组)及80例无眩晕(对照组)的患者进行颅颈动态增强磁共振血管成像(DCE-MＲA)检查，测量其颈段直线距离及颈段椎动脉长度，计算其延长值，评价椎动脉扭曲程度。结果经DCE-MＲA检查排除椎-基底动脉有明显狭窄闭塞性改变的患者27例，其中眩晕组9例，对照组18例。眩晕组两侧椎动脉延长值均显著长于对照组(P＜0.05～0.

2、01)。相关分析显示，左右两侧椎动脉延长值与颈源性眩晕相关(r=0.275，r=0.255;均P＜0.05)，左侧椎动脉延长值与年龄呈正相关(r=0.216，P=0.027)，颈段直线距离与年龄呈负相关(r=－0.219，P=0.025)。结论椎动脉扭曲源于其颈段缩短，与颈源性眩晕发作有关。【关键词】椎动脉;血管扭曲;颈源性眩晕【中图分类号】Ｒ681．5【文献标识码】A【文章编号】1004-1648(2013)04-0306-03Ｒelationshipbetweenvertebralarterydistortionandcervicalv

3、ertigoJUKe-ju，CHENGGuan-liang，CAOHua，etal．DepartmentofNeurology，Huai'anFirstPeople'sHospitalAffiliatedtoNanjingMedicalUniversity，Huai'an223300，ChinaAbstract:ObjectiveToinvestigatetherelationshipbetweenvertebralarterydistortionandcervicalvertigo．MethodsThirty-onesuspectedce

4、rvicalvertigopatients(vertigogroup)and80non-vertigopatients(controlgroup)wereexaminedwithdynamiccontrast-enhancedmagneticresonanceangiography(DCE-MＲA)．Cervicalstraightlinedistanceandthelengthofvertebralarteryweremeasured，andthelengtheningvaluewascalculated．Thedegreeofverte

5、bralarterydistortionwasevaluatedlater．ＲesultsTwenty-sevenpatientsfoundseverevertebral-basalarterialstenosisorobliterationbyDCE-MＲAwereeliminated，andvertigogroupwasin9cases，controlgroupin18cases．Thelengtheningvalueofbilateralcarotidarteryinvertigogroupweresignificantlylonge

6、rthanthoseincontrolgroup(P＜0.05－0.01)．Correlationanalysisshowedthelengtheningvalueofvertebralarteryinleftsideandrightsidewererelatedtocervicalvertigo(r=0.275，r=0.255;allP＜0.05)．Therewasapositivecorrelationbetweenlengtheningvalueofvertebralarteryinleftsideandage(r=0.216，P=0

7、.027)．Therewasanegativecorrelationbetweencervicallengthofvertebralarteryandage(r=－0.219，P=0.025)．ConclusionVertebralarterydistortionistheresultofshortenedcervicallength，anditisrelatedwithcervicalvertigo．Keywords:vertebralartery;vasculardistortion;cervicalvertigo颈椎病是常见的一种退行

8、性疾病，包括脊髓型、4.73)d;合并高血压9例，糖尿病2例。(2)对照组:神经根型、食管型、交感神经型和椎动脉型等，通过临为同期住院的其他疾病患者80例，均无眩晕症状。床及影像