椎动脉血流动力学参数联合血清CGRP检测对颈性眩晕患者疗效的评估价值

Assessment value of vertebral artery hemodynamic parameters combined with serum CGRP detection for therapeutic effect in patients with cervical vertigo

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摘要目的观察颈性眩晕患者超声检查椎动脉血流动力学参数及血清降钙素基因相关肽(calcitonin generelated peptide,CGRP)水平的变化,探讨其对颈性眩晕治疗效果的评估价值。方法选取108例颈性眩晕患者并设为研究组进行回顾性分析,再选取同期健康志愿者36例作为对照组。比较两组椎动脉血流动力学参数[左侧椎动脉(left vertebral artery,LVA)、右侧椎动脉(right vertebral artery,RVA)、基底动脉(basilar artery,BA)收缩期最大血流速度(systolic maximum blood flow velocity,V_(max))]和血清CGRP水平。比较研究组不同眩晕程度患者LVA-V_(max)、RVA-V_(max)、BA-V_(max)及血清CGRP水平。研究组予以常规治疗,依据治疗1个月后的效果分为有效亚组74例、无效亚组34例,并比较其临床资料及治疗前后LVA-V_(max)、RVA-V_(max)、BA-V_(max)、血清CGRP水平。分析治疗效果的影响因素,并探讨LVA-V_(max)、RVAV_(max)、BA-V_(max)、血清CGRP水平对治疗效果的评估价值。结果研究组LVA-V_(max)、RVA-V_(max)、BA-V_(max)及血清CGRP水平均低于对照组(均P<0.01);LVA-V_(max)、RVA-V_(max)、BA-V_(max)及血清CGRP水平排序:眩晕重度者<中度者<轻度者(均P<0.05)。无效亚组治疗1个月后LVA-V_(max)、RVA-V_(max)、BA-V_(max)及血清CGRP水平均低于有效亚组(均P<0.01)。多因素Logistic回归分析显示,年龄、病程为治疗效果的危险因素,LVA-V_(max)、RVA-V_(max)、BA-V_(max)及血清CGRP水平为治疗效果的保护因素(均P<0.05)。治疗1个月后LVA-V_(max)、RVA-V_(max)、BA-V_(max)及血清CGRP水平联合评估治疗效果的AUC值大于单项指标评估(均P<0.01)。结论颈性眩晕患者超声检查参数LVA-V_(max)、RVA-V_(max)、BA-V_(max)及血清CGRP水平降低,且与眩晕程度、治疗效果有关,联合检测其水平对治疗效果具有一定评估价值。 Objective To observe the changes in vertebral artery hemodynamic parameters by ultrasonic examination and serum calcitonin gene-related peptide(CGRP)level in patients with cervical vertigo,and to explore their assessment value for the therapeutic effect on cervical vertigo.Methods A retrospective analysis was conducted on 108 patients with cervical vertigo(designated as a study group),while 36 healthy volunteers were selected during the same period as a control group.The vertebral artery hemodynamic parameters[systolic maximum blood flow velocity(V_(max))of the left vertebral artery(LVA),right vertebral artery(RVA),and basilar artery(BA)],and serum CGRP level were compared between the two groups.The LVA-V_(max),RVA-V_(max),BA-V_(max),and serum CGRP level in patients with different severities of vertigo were compared in the study group.The study group received routine treatment,and was divided into an effective subgroup with 74 cases and an ineffective subgroup with 34 cases based on the therapeutic effect after one month of treatment.The clinical data,and LVA-V_(max),RVA-V_(max),BA-V_(max) and serum CGRP level before and after treatment were compared between the two subgroups.The influencing factors of efficacy were analyzed;the values of LVA-V_(max),RVA-V_(max),BA-V_(max) and serum CGRP level in assessing the treatment efficacy were explored.ResultsThe LVA-V_(max),RVA-V_(max),BA-V_(max),and serum CGRP level in the study group were all lower than those in the control group(all P<0.01).The levels of LVA-V_(max),RVA-V_(max),BA-V_(max),and serum CGRP in the study group were ranked in ascending order as follows:patients with severe vertigo<those with moderate vertigo<those with mild vertigo(all P<0.05).After one month of treatment,the LVA-V_(max),RVA-V_(max),BA-V_(max),and serum CGRP level in the ineffective subgroup were all lower than those in the effective subgroup(all P<0.01).Multivariate Logistic regression analysis showed that age and disease duration were risk factors for treatment efficacy,while LVA-V_(max),RVA-V_(max),BA-V_(max),and serum CGRP level were protective factors for treatment efficacy(all P<0.05).After one month of treatment,the AUC value of the combined LVA-V_(max),RVA-V_(max),BA-V_(max),and serum CGRP level for assessing treatment efficacy was greater than that of any individual indicator(all P<0.01).Conclusion Patients with cervical vertigo exhibit reduced ultrasonic examination parameters including LVA-V_(max),RVA-V_(max) and BA-V_(max),and serum CGRP level,which are associated with the severity of vertigo and treatment efficacy.Combined detection of these parameter levels offers certain assessment value for treatment efficacy.

作者晁胜艳陈洁如谢志飞韩如冰 CHAO Shengyan;CHEN Jieru;XIE Zhifei;HAN Rubing(Department of Ultrasound Diagnosis,Puyang People's Hospital,Puyang Henan 457000,China)

机构地区濮阳市人民医院超声诊断科

出处《实用心电与临床诊疗》 2025年第2期188-193,共6页 PRACTICAL ELECTROCARDIOLOGY AND CLINICAL TREATMENT

基金河南省医学科技攻关联合共建项目(LHGJ20195199)。

关键词颈性眩晕椎动脉血流动力学参数降钙素基因相关肽椎动脉基底动脉 cervical vertigo vertebral artery hemodynamic parameter calcitonin gene-related peptide vertebral artery basal artery

分类号 R741 [医药卫生—神经病学与精神病学]

作者简介晁胜艳,主要从事超声诊断相关研究,E-mail:sheng11yan@163.com。