翻转现象：吞咽诱导的动脉移位作为颈动脉疾病的一个指标

Flip-Flop Phenomenon: Swallowing-Induced Arterial Displacement as an Indicator of Carotid Artery Disease.

作者信息

Kinoshita Naoto, Saito Kozue, Yamaguchi Yoshitaka, Abe Soichiro, Wada Shinichi, Tanaka Tomotaka, Kajimoto Katsufumi, Yamagami Hiroshi, Maruyama Hirofumi, Toyoda Kazunori, Ihara Masafumi, Nagatsuka Kazuyuki

机构信息

Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan.

Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan.

出版信息

Cerebrovasc Dis. 2018;45(5-6):258-262. doi: 10.1159/000490180. Epub 2018 Jun 7.

DOI:10.1159/000490180

PMID:29879697

Abstract

BACKGROUND AND PURPOSE

The dynamic displacement of the carotid arteries with interference of the hyoid bone during swallowing, named as "flip-flop" phenomenon (FFP), may be associated with ischemic stroke. However, the extent to which FFP is prevalent in carotid artery disease remains unknown. We aimed to investigate its exact prevalence to explore the relationship between FFP and carotid artery disease.

METHODS

We examined 202 consecutive patients who were affected by neurological diseases including cerebrovascular diseases. Using carotid ultrasound, we evaluated carotid intima-media thickness, internal carotid artery stenosis (ICS), and FFP during swallowing with neck rotation.

RESULTS

FFP was observed in 39 of the 202 patients (19.3%). Patients with FFP showed significantly higher prevalence of ICS than those without FFP (12/39 [30.8] vs. 21/163 [12.9%]; p = 0.007). Among those with ICS (n = 33; 36 vessels), FFP was associated with symptomatic ICS more frequently than with asymptomatic ICS (6/11 [54.5] vs. 5/25 [20.0%]; p = 0.038). Among those with unilateral FFP (n = 37), the prevalence of ipsilateral ICS was higher than that of contralateral ICS (9/37 [24.3] vs. 2/37 [5.4%]; p = 0.035).

CONCLUSIONS

FFP accompanies the swallowing movement in some neurological patients, and more frequently in patients with ICS. FFP may thus be a novel indicator of stroke.

摘要

背景与目的

吞咽过程中舌骨干扰导致的颈动脉动态移位，即“翻转”现象（FFP），可能与缺血性卒中相关。然而，FFP在颈动脉疾病中的普遍程度尚不清楚。我们旨在调查其确切患病率，以探讨FFP与颈动脉疾病之间的关系。

方法

我们检查了202例连续患有包括脑血管疾病在内的神经系统疾病的患者。使用颈动脉超声，我们评估了颈动脉内膜中层厚度、颈内动脉狭窄（ICS）以及吞咽时颈部旋转情况下的FFP。

结果

202例患者中有39例（19.3%）观察到FFP。有FFP的患者ICS患病率显著高于无FFP的患者（12/39 [30.8%] 对21/163 [12.9%]；p = 0.007）。在有ICS的患者中（n = 33；36条血管），FFP与有症状的ICS相关的频率高于与无症状的ICS相关的频率（6/11 [54.5%] 对5/25 [20.0%]；p = 0.038）。在有单侧FFP的患者中（n = 37），同侧ICS的患病率高于对侧ICS（9/37 [24.3%] 对2/37 [5.4%]；p = 0.035）。