介入支架植入术治疗颈动脉狭窄的临床研究及对炎症因子、凝血功能、神经功能的影响  

Clinical Study of Interventional Stent Implantation for Carotid Artery Stenosis and Its Effects on Inflammatory Factors,Coagulation Function and Neurological Function

作　　者：田荣[1] 毛更生[1] 李冬梅 杜世伟[1] 聂庆彬[1] 孙剑[1] 陈琳[1] 张煜丹 Tian Rong Mao Gengsheng Li Dongmei Du Shiwei Nie Qingbin Sun Jian Chen Lin Zhnng Yudan(Chinese People＇s Armed Police Force General Hospital,Beijing 100039, China)

机构地区：[1]中国人民武装警察部队总医院,北京100039

出　　处：《中西医结合心脑血管病杂志》2017年第9期1124-1128,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的分析介入支架植入术治疗颈动脉狭窄的临床治疗效果及其对炎症因子、凝血功能及神经功能的影响。方法选取我院门诊和住院部收治的76例颈动脉狭窄病人作为研究对象,按照不同治疗方法分为试验组和对照组,每组38例。对照组应用颈动脉造影治疗,试验组采取介入支架植入术治疗。观察两组临床治疗效果、炎症因子变化情况、凝血因子变化情况、神经功能缺损情况和生活能力以及并发症情况。结果治疗后,两组美国国立卫生研究院卒中量表(NIHSS)评分和Modified Rankin Scaje9(MRS)评分均较治疗前有改善,且试验组评分情况均较对照组更低(P<0.05)。试验组术后各炎症因子指标水平均较对照组更高,可持续一周,其术后变化水平较术前有明显统计学意义(P<0.05)。试验组术后的纤维蛋白原水平(FIB)、D-二聚体(DD)、纤维蛋白原降解产物水平(FDP)水平以及术后1d的凝血酶原时间(PT)和活化部分凝血活酶时间(APTT)均高于对照组(P<0.05)。两组评分较治疗前显著改善(P<0.05),同时,试验组的Barthel指数机堪的那维亚神经卒中量表(SSS)评分情况均明显优于对照组(P<0.05)。试验组并发症发生情况显著高于对照组,两组总并发症发生率比较有统计学意义(P<0.05)。结论应用介入支架植入术治疗颈动脉狭窄病人的临床效果较为显著,虽然对病人凝血因子水平、炎症因子水平以及神经功能有一定影响,但其水平均在术后1周有明显改善。Objective To study the clinical effect of interventional stent implantation for carotid artery stenosis and its effects on inflam-matory factors, coagulation function and neurological function. Methods Seventy - six patients with carotid stenosis were selected and divided into two groups：control group （ n = 38） treated with carotid angiography,and treatment group （ n = 38） treated with in-terventional stent implantation. The clinical treatment effect,the changes of inflammatory factors, coagulation factors, and neurological deficits, daily living ability and complications were observed. Results After treatment, the scores of National Institutes of Health Stroke Scale （NIHSS） and Rankin Scale in two groups were significantly improved,which was lower in treatment group than that in control group （ P 〈0.05）. The levels of inflammatory factors in treatment group were higher than that in control group,which lasted for one week, and the level of postoperative changes was significant compared with preoperative （ P 〈0.05）. The levels of fibrinogen （FIB）,D- dimer （DD）, fibrin degradation product （FDP） after operation and prothrombin time （PT） and activated partial thrombo-plastin time （APTT） in treatment group were significantly higher than those in control group at 1st day after operation （ P 〈 0.05）.The scores of Barthel index and Scandinavian Stroke Scale （SSS） in treatment group were significantly improved and better than those in control group （ P 〈0.05） .The incidence of complications in treatment group was significantly higher than that in the control group （ P 〈0.05） . Conclusion The clinical effect of interventional stent implantation in the treatment of carotid artery stenosis is sig-nificant, although the levels of coagulation factors, inflammatory factors and neurological function have a certain impact in patients with carotid stenosis,which was significantly improved after 1 week of surgery.

关 键 词：颈动脉狭窄 介入支架植入 炎症因子 凝血因子 神经功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]