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梅尼埃病患者的慢性脑脊髓静脉功能不全

Chronic cerebrospinal venous insufficiency in patients with Ménière's disease.

作者信息

Filipo R, Ciciarello F, Attanasio G, Mancini P, Covelli E, Agati L, Fedele F, Viccaro M

机构信息

Department of Sensory Organs, Umberto I Polyclinic of Rome, "Sapienza" University, viale dell'Università 31, 00161, Rome, Italy.

出版信息

Eur Arch Otorhinolaryngol. 2015 Jan;272(1):77-82. doi: 10.1007/s00405-013-2841-1. Epub 2013 Dec 7.

Abstract

To analyze the presence of chronic cerebrospinal venous insufficiency parameter and vascular abnormalities, in the internal jugular veins (IJVs) and/or vertebral veins in sitting and supine posture, in patients with Meniere's disease compared to healthy general population. A prospective study on 32 patients affected by definite Ménière was performed from February 2012 to January 2013. All subjects underwent an echo-color Doppler examination of the cerebrospinal venous flow. 21 of the 32 Menieric patients showed a statistically significant reflux in the intracranial veins versus healthy (65.6 vs 25%; P < 0.001). A high prevalence of IJVs stenosis with hemodynamic changes (increased velocity or absence of flow) was observed (66.7 vs 33.3%; P < 0.05). The other parameters considered did not show statistically significant differences among the two groups. The results obtained showed a vascular pattern of cerebrospinal venous system present in patients affected by definite Meniere. This vascular impairment significantly affects the vascular areas more directly involved in the venous drainage of the inner ear. Thus venous stasis may be considered a further pathogenetic mechanism for development of Meniere's disease.

摘要

为分析梅尼埃病患者与健康普通人群相比,在坐位和仰卧位时颈内静脉(IJVs)和/或椎静脉中慢性脑脊髓静脉功能不全参数及血管异常的存在情况。2012年2月至2013年1月对32例确诊为梅尼埃病的患者进行了一项前瞻性研究。所有受试者均接受了脑脊髓静脉血流的彩色多普勒超声检查。32例梅尼埃病患者中有21例颅内静脉出现统计学上显著的反流,而健康人群中这一比例为25%(65.6%对25%;P<0.001)。观察到颈内静脉狭窄伴血流动力学改变(流速增加或无血流)的发生率较高(66.7%对33.3%;P<0.05)。两组间其他所考虑的参数未显示出统计学上的显著差异。所得结果显示,确诊为梅尼埃病的患者存在脑脊髓静脉系统的血管模式。这种血管损伤显著影响了内耳静脉引流更直接涉及的血管区域。因此,静脉淤滞可被视为梅尼埃病发病的另一种致病机制。

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