大脑中动脉支架置入术对脑血管反应性的影响  

Cerebral vasoreactivity changes before and after middle cerebral artery stenting

作　　者：范进[1] 李倩[1] 孙文[1] 朱慧敏[1] 孔丽[1] 芮志凤[2] 林敏[3] 

机构地区：[1]第二军医大学南京临床医学院南京军区南京总医院神经内科,南京210002 [2]第二军医大学南京临床医学院南京军区南京总医院超声诊断科,南京210002 [3]福建医科大学福州临床医学院南京军区福州总医院神经内科,福州350025

出　　处：《中华神经医学杂志》2011年第5期445-448,共4页Chinese Journal of Neuromedicine

基　　金：国家自然科学基金（30870847）;南京军区总医院科研课题（2009M008）

摘　　要：目的 探讨大脑中动脉支架置入术对脑血管反应性（CVR）的影响及心肌梗死溶栓分级（TIMI）与CVR之间的关系.方法 选择行大脑中动脉支架置人术的卒中患者39例作为手术组,选择同期非卒中患者48例作为对照组.经颅多普勒（TCD）结合CO2吸人试验检测手术前后CVR的变化,DSA造影明确卒中血管TIMI分级,并对相关数据进行统计学分析.结果 手术组患者术前CVR明显低于对照组,术后CVR较术前明显提高,比较差异有统计学意义（P〈0.05）.术前CVR与TIMI分级呈正相关（R=0.594,P〈0.05）,TIMI分级1级和2级之间术前CVR比较差异有统计学意义（P〈0.05）,2级和3级之间术前CVR比较差异无统计学意义（P〉0.05）.术后CVR改善幅度与术前CVR呈负相关（R=-0.760,P〈0.05）,与TIMI等级亦呈负相关（R=-0.620,P〈0.05）.结论 大脑中动脉支架置入术能有效改善患者CVR.Objective To explore the cerebral vasoreactivity （CVR） changes before and after middle cerebral artery stenting （MCAS） and the relationship between thrombolysis in yocardial infarction（TIMI）flow grade and CVR. Methods Thirty-nine patients with middle artery stenosis received MCAS treatment were selected as operated group and 48 non-stroke hospitalized patients at the same period as control group. Transcranial Doppler （TCD） combined with CO2 inhalation test was performed to assess the changes of CVR before and after MCAS. Digital subtraction angiography （DSA） was employed to assess the TIMI flow grade. These data were statistically analyzed. Results As compared with that of the control group, preoperative CVR of the operated group was significantly reduced （P〈0.05）; the postoperative CVR significantly increased as compared with the preoperative one in the operated group （P〈0.05）; preoperative CVR was positively correlated with the TIMI grade （R=0.594, P〈0.05）. Preoperative CVR had a significant difference between TIMI grade 1 and TIMI grade 2 （P〈0.05）, but not between TIMI grade 2 and TIMI grade 3 （P〉0.05）. The degree of CVR improvement was negatively correlated with the TIMI grade （R=-0.620, P〈0.05） and preoperative CVR （R=-0.760,P〈0.05）. Conclusion MCAS can effectively improve the CVR.

关 键 词：大脑中动脉 支架 脑血管反应性 经颅多普勒 

分 类 号：R743.3[医药卫生—神经病学与精神病学]