介入支架治疗颈动脉狭窄患者术后凝血因子和炎症因子变化的研究  

Clinical Application of Carotid Artery Stenting in Patients with Carotid Artery Stenosis

作　　者：苑杨[1] 钟华[2] 杜世伟[3] 

机构地区：[1]新疆医科大学第二附属医院神经外科,830028 [2]新疆医科大学第二附属医院介入中心,830028 [3]北京武警总医院神经血管外科

出　　处：《天津医药》2013年第4期330-333,共4页Tianjin Medical Journal

摘　　要：目的观察颈动脉狭窄患者行颈动脉支架术后凝血因子和血清炎症因子的变化,探讨其与术后并发症可能存在的关系。方法回顾性分析2009年—2012年收治的62例颈动脉狭窄患者的临床资料,将入组的62例患者按照治疗方法分为介入支架植入术组(支架组,22例)和正常造影组(40例),检测2组患者术前,术后1、3、7d凝血因子和血清炎症因子变化。结果 2组患者术前的凝血因子和血清炎症因子差异无统计学意义,凝血因子均于术后7d接近术前水平,支架组术后1d的凝血因子凝血酶原时间(PT)、D-二聚体(DD)、纤维蛋白原降解产物(FDP)、术后3d各凝血因子以及术后7d的FDP均高于造影组。造影组仅造影术后1d的超敏C-反应蛋白(hs-CRP)、白介素(IL)-6和IL-8出现明显升高,支架组hs-CRP术后1d和IL-8只有术后1、3d与术前差异有统计学意义,术后其他凝血因子均出现明显变化,可持续1周。支架组术后的hs-CRP在1、7d,肿瘤坏死因子(TNF)-α在1、3、7d,IL-6在3、7d,IL-8在1、3d均与造影组相比差异有统计学意义。支架组并发症发生率(40.9%)高于造影组(2.5%)。结论颈动脉支架植入术对于患者的凝血因子水平以及血清炎症因子水平有明显影响,凝血因子升高可持续至术后1周。Objective To observe the serum changes of coagulation factor and inflammatory factor in patients with carotid artery stenosis after carotid artery stent operation, and discuss the possible relationship between these changes and postoperative complications. Methods The clinical data of 62 patients with carotid artery stenosis from 2009 to 2012 in our hospital were retrospectively analyzed. Patients were divided into two groups according to the therapeutic method, including stent implantation group （n=22） and normal angiography group （n=40）. The serum levels of coagulation factor and inflammatory factor were detected 1, 3 and 7 days after operation in two groups. Results There were no significant differences in serum coagulation factor and inflammatory factor before operation between two groups. The serum level of coagulation factor recovered to near the preoperative level after 7 days in two groups. There were higher levels of prothrombin time （PT）, D-dimer （DD） and fibrinogen degradation product （FDP） 1 day after operation in stent implantation group than those of normal angiography group. The serum levels of coagulation factors were significantly higher 3 days after operation and FDP was significanty higher 7 days after operation in stent implantation group than those of normal angiography group. The levels of high-sensitivity C-reactive protein （hs-CRP）, interleukin （IL）-6 and IL-8 were significantly higher in normal angiography group 1 day after operation. There were significant differences in hs-CRP （1 day after operation ） and IL-8 （1 day and 3 days after operation, and before operation） in stent implantation group. Other serum coagulation factors showed significant changes after operation and continued for 1 week. There were significant differences in hs-CRP （1 day and 7 days after operation）tumor necrosis factor （TNF）-a （1, 3 and 7 days after operation）, IL-6 （3 and 7 days after operation） and IL-8 （1 and 3 days after operation） between stent implanta

关 键 词：颈动脉狭窄 支架 血管造影术 血液凝固因子 肿瘤坏死因子α 白细胞介素6 白细胞介素8 C反应蛋白质 

分 类 号：R541.4[医药卫生—心血管疾病]