针刺对可降解脑血管支架材料置入后康复效果及生物相容性的影响  

Acupuncture following degradable cerebrovascular stent implantation:rehabilitation efficacy and stent biocompatibility

作　　者：李小宏[1] 余和平[1] 曹万群[1] 

机构地区：[1]重庆医科大学附属第一医院康复医学科,重庆市400016

出　　处：《中国组织工程研究》2015年第21期3382-3386,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:颅内外动脉支架置入是脑血管病治疗的主要手段,特别对一些无法耐受外科手术的患者显示出显著优越性,但置入后康复及生物相容性等问题制约了该项技术的进一步发展。目的:探讨针刺对可降解脑血管支架材料置入后康复效果及生物相容性的影响。方法:纳入脑动脉狭窄患者70例,其中男41例,女29例,年龄43-79岁,均进行药物涂层可降解脑血管内支架置入治疗,其中颈动脉支架31例,椎动脉支架21例,锁骨下支架5例,大脑中动脉支架13例。支架置入后随机均分两组,对照组采用常规康复治疗,针刺组在对照组基础上联合头电针刺理疗,治疗3个月后评估两组神经功能缺损程度评分、简化Fugl-Meyer(FMA)运动功能评分、Barthel指数评定量表得分,以及支架处血管狭窄度和血栓素A2、前列环素、血栓素A2/前列环素水平。结果与结论:治疗3个月后,针刺组神经功能缺损得分显著低于对照组(P<0.05),FMA、Barthel指数得分显著高于对照组(P<0.05);两组血栓素A2、血栓素A2/前列环素均低于治疗前(P<0.05),前列环素高于治疗前(P<0.05),两组间血栓素A2、血栓素A2/前列环素、前列环素比较差异无显著性意义;针刺组再狭窄率显著低于对照组(P<0.05),两组间参考血管直径、支架血管直径、血管直径减少指数、再介入率等血管狭窄参数比较差异无显著性意义(P>0.05)。说明针刺能够促进可降解脑血管支架材料置入后的康复效果,降低再狭窄发生率,显示了良好的生物相容性。BACKGROUND：Intracranial and extracranial arterial stent implantation is the main therapy for cerebrovascular diseases, especialy for some patients who cannot tolerate surgical operation, but the postoperative rehabilitation and biocompatibility problems restrict the further development of the technology. OBJECTIVE：To explore the rehabilitation efficacy and biocompatibility of acupuncture after degradable cerebrovascular stent implantation. METHODS： A total of 70 patients with cerebral arterial stenosis aged 43-79 years were enroled, including 41 males and 29 females, who were al treated with drug-eluting stent implantation, carotid artery stent implantation in 31 cases, vertebral artery stent implantation in 21 cases, subclavian stent implantation in 5 cases, and middle cerebral artery stent implantation in 13 cases. After stent implantation, al the patients were randomly divided into two groups： control group with routine rehabilitation therapy and acupuncture group with routine rehabilitation therapy＋electroacupuncture. After 3 months of treamtnet, neurologic impairment scores, Fugl-Meyer score for motor function, Barthel index, degree of stent stenosis, thromboxane A2, prostacyclin, thromboxane A2/ prostacyclin levels were detected. RESULTS AND CONCLUSION：At 3 months after treatment, the neurological impairment scores were significantly lower in the acupuncture group than the control group （P 0.05）. Taken together, acupuncture can promote the rehabilitation efficacy folowing degradable cerebrovascular stent implantation, reduce the incidence of restenosis, and show good biocompatibility.

关 键 词：支架 生物材料 材料相容性 针刺 脑血管支架 生物相容性 脑动脉狭窄 康复 

分 类 号：R318[医药卫生—生物医学工程]