目的 探讨经颅多普勒超声（TCD）与彩色多普勒血流成像（CDFI）联合评价锁骨下动脉病变的血流动力学变化及临 床价值。方法 回顾性分析45例经TCD和CDFI联合检测的锁骨下动脉（SA），根据CDFI检测结果把SA病变分为轻度 狭窄（狭窄程度<50%）；中度狭窄（50%∽69%），重度狭窄（70∽99%和闭塞（100%）四个组，并将各组检查结果 与TCD检测的颅内动脉盗血程度（分为椎动脉无盗血，Ⅰ期盗血，Ⅱ期盗血和Ⅲ期盗血四组）进行对照分析。分析 CDFI与TCD检测各组中脉压差各值。结果 无盗血，Ⅰ期盗血，Ⅱ期盗血和Ⅲ期盗血四组患者双上肢血压差值分别为 5.8±3.1，13.6±9.2，28.2±13.2，39.3±10.2mmHg。各组间比较有显著性差异（p<0.01）；轻度狭窄，中度狭 窄，重度狭窄和闭塞四个组患者双上肢血压差值分别为7.9±4.7，20.6±10.2，32.8±13.2，40.6±16.2mmHg。 各组间比较有显著性差异（p<0.01）。TCD检查无盗血的8例患者中，CDFI示轻度狭窄6例，中度狭窄2例；TCD检查 Ⅰ期盗血的21例患者中，CDFI示轻度狭窄12例，中度狭窄9例；TCD检查Ⅱ期盗血的11例患者中，CDFI示中度狭窄3 例，重度狭窄7例；闭塞1例；TCD检查Ⅲ期盗血的5例患者中，CDFI示重度狭窄3例；闭塞2例。结论 患者双上肢脉 压差大小可初步反映SA的病变程度及椎动脉的盗血程度。TCD与CDFI检测SA病变具有高度的相关性，TCD与CDFI联合 检测，可观察SA内径变化，血管走行，血流动力学变化及颅内外血流代偿情况，有助于临床综合评价

Objective To imvestigate transcranial Doppler (TCD) and color Doppler flow imaging (CDFI) changes of hemodynamics of subclavian artery lesions and clinical value of combined evaluation. Methods A retrospective analysis of 45 cases of clavicle by TCD and CDFI combined detection of artery (SA), according to the SA CDFI test results were divided into mild stenosis (stenosis <50%); moderate stenosis (50% ~ 69%), severe stenosis and occlusion (70 - 99% (100%) of four groups, and each test results and TCD detection of intracranial artery steal degree (divided into vertebral artery not steal, stage I steal, steal and stage II III steal four groups) were analyzed. Analysis of CDFI and TCD detected the midrib pressure difference value. Results No steal steal, phase I, phase II and III steal steal four groups of patients with double upper limbs blood pressure difference were 5.8 + 3.1, 13.6 + 9.2 and 28.2 + 13.2 and 39.3 + 10.2mmHg. There was significant difference in the comparison between the groups (p<0.01); mild stenosis, moderate stenosis, severe stenosis and occlusion of four groups of patients with double upper limbs blood pressure difference were 7.9 + 4.7, 20.6 + 10.2 and 32.8 + 13.2 and 40.6 + 16.2mmHg. There was significant difference in the comparison between the groups (p<0.01). TCD examination of 8 cases of patients with no steal in CDFI showed 6 cases, mild stenosis, moderate stenosis in 2 cases; TCD examination in 21 cases of stage I steal patients, CDFI showed mild stenosis in 12 cases, moderate stenosis in 9 cases; TCD examination in 11 cases of stage II steal patients, CDFI showed moderate stenosis in 3 cases, severe stenosis in 7 cases; 1 cases of occlusion; TCD examination in 5 cases of stage III steal patients, CDFI showed 3 cases of severe stenosis and occlusion in 2 cases. Conclusion The patients of upper limbs pulse pressure size can be preliminarily reflect severity and vertebral artery SA steal degree. TCD and CDFI for detection of SA lesions are highly related, the combined detection of TCD and CDFI, can observe the changes of the diameter of SA, vascular, change of hemodynamics and intracranial and extracranial compensatory blood flow, contribute to the clinical comprehensive evaluation.