颈动脉支架置入术后颅内血管反应性动态观察  

Dynamic observation of cerebral vasoreactivity after carotid angioplasty and stenting

作　　者：朱慧敏[1] 翟登月[1] 殷勤[1] 洪震[1] 周志明[1] 徐格林[1] 刘新峰[1] 

机构地区：[1]南京大学医学院临床学院(南京军区南京总医院)神经内科,南京210002

出　　处：《中华神经医学杂志》2011年第1期66-69,共4页Chinese Journal of Neuromedicine

基　　金：南京军区十一五重点课题（082026）;中国博士后基金（20080431416）

摘　　要：目的 探讨颈动脉支架置入术（CAS）后脑血管反应性（CVR）的变化规律及影响CVR的相关因素.方法 选择自2008年7月至2009年9月南京军区南京总医院神经内科行CAS并完成随访的37例患者,采用经颅多普勒超声（TCD）结合屏气试验检测术前、术后1～2d和随访3～10月时双侧大脑中动脉的屏气指数（BHI）.采用重复测量设计的方差分析检测支架置入术前后BHI的变化规律,并采用多元回归法分析影响最终BHI的相关因素.结果 37例患者术后手术侧BHI均较术前明显提高（P＜0.05）.随访时的BHI与术后BHI呈正相关（β=1.030,P=0.000）,串联狭窄与随访时的BHI呈负相关（β=-0.016,P=0.002）.结论 CAS能立即改善术侧CVR使之逐渐接近正常,串联狭窄是影响最终CVR的独立危险因素.Objective To explore the changes and influencing factors of cerebral vasoreactivity （CVR） in patients after carotid angioplasty and stenting （CAS）. Methods Thirty-seven patients performed CAS, admitted to our hospital from July 2008 to September 2009, were finished the follow-up and chosen in our study; the breath-holding index （BHI） of the bilateral middle cerebral artery was measured using transcranial Doppler combined with breath holding test before thc operation, and 1 d and 3-10 months after the operation. Repeated measures design analysis of variance was employed to detect the BHI changes before and after the stenting; multiple regression was employed to analyze the influencing factors of BHI. Results BHI values after stenting were significantly higher than those before stenting on the stenotic side （P〈0.05）. The follow-up BHI values were negatively correlated with those of tandem stenoses （β=-0.016, P=0.002） and positively correlated with the postoperative BHI values （β=1.030, P=0.000）. Conclusion CAS can immediately improve CVR on the ipsilateral side and make it close to normalization gradually. Tandem stenoses are the independent risk factors of CVR.

关 键 词：颈动脉狭窄 颈内动脉支架置入术 屏气指数 随访 

分 类 号：R743.3[医药卫生—神经病学与精神病学]