椎动脉不同部位重度狭窄或闭塞的血流动力学参数与后循环缺血的相关性

doi:10.3969/j.issn.1671-7171.2022.12.002

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Abstract 【Objective】To explore the relationship of hemodynamic parameters of severe stenosis or occlusion of vertebral artery (VA) with posterior circulation ischemia (PCI). 【Methods】From September 2019 to March 2021,150 patients with severe stenosis or occlusion of V1~V4 segment of unilateral VA diagnosed by carotid ultrasound,angiography and angiography were retrospectively analyzed. According to the location of severe stenosis or occlusion VA,they were divided into the V1 segment (84 cases),V2 segment (9 cases) and V3 ~ V4 segment (57 cases). Carotid artery ultrasound was used to check and record the hemodynamic parameters of each part of VA. ROC was used to analyze the hemodynamic parameters of V1~V4 segments to predict the value of severe stenosis or occlusion of VA. Logistic stepwise regression analysis was used to test the correlation between hemodynamic parameters and PCI. 【Results】In severe stenosis or occlusion of V1 and V2 segments,peak systolic blood velocity (PSV),end diastolic blood velocity (EDV) and vascular resistance index (RI) of the affected side were significantly lower than those of the healthy side,and the diameter of VA intervertebral segment (VAD) was thinner than that of the healthy side. When V3~V4 segment was severely narrowed or occluded,the PSV and EDV of the affected side were significantly lower than those of the healthy side,and the VAD was thinner than that of the healthy side (P<0.05). When V3~V4 segment was severely narrowed or occluded,there was no difference in RI between the affected side and the healthy side (P>0.05). Through ROC analysis,it was found that the levels of PSV,EDV,RI,VAD in V1~V2 and PSV,EDV and VAD levels in V3~V4 can be used to predict the severe stenosis or occlusion of VA. Multivariate analysis showed that there was no significant correlation between PCI and severe stenosis or occlusion in V1 and V2 segments,while PSV,EDV and VAD in V3~V4 segments were significantly correlated with PCI,which were independent risk factors for PCI,while RI in V3~V4 segments had no significant correlation with PCI. 【Conclusion】PCI is related to V3-V4 segment stenosis or occlusion. The lower PSV,EDV and the thinner VAD can increase the risk of PCI.

Key words： Vertebrobasilar Insufficiency Hemodynamics Brain Infarction

Received: 16 July 2022

PACS:

R743.33

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http://journal07.magtech.org.cn/yxlcyj/EN/10.3969/j.issn.1671-7171.2022.12.002 OR http://journal07.magtech.org.cn/yxlcyj/EN/Y2022/V39/I12/1764

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