颈动脉狭窄介入治疗对脑微出血的影响  

Effect of interventional treatment of carotid artery stenosis on cerebral microbleeds

作　　者：张军[1] 赵娴[2] 曹献国 宋哲[1] 刘惠钦[1] ZHANG Jun;ZHAO Xian;CAO Xian-guo;SONG Zhe;LIU Hui-qin(Department of Neurology,the First Hospital of Shijiazhuang,Hebei Province,Shijiazhuang050011,China;Department of Ophtholmology,the First Hospital of Shijiazhuang,Hebei Province,Shijiazhuang 050011,China)

机构地区：[1]河北省石家庄市第一医院神经内科,河北石家庄050011 [2]河北省石家庄市第一医院眼科,河北石家庄050011

出　　处：《河北医科大学学报》2018年第11期1253-1256,1261,共5页Journal of Hebei Medical University

基　　金：石家庄市科学技术研究与发展指导计划(141462463)

摘　　要：目的探讨缺血性脑卒中患者颈动脉支架成形术(carotid angioplasty and stenting,CAS)后脑微出血(cerebral microbleeds,CMBs)的变化情况。方法选取颈动脉血管狭窄≥70%的缺血性脑卒中患者67例作为A组,经数字减影血管造影(digital subtraction angiography,DSA)检查符合介入治疗指征,行CAS治疗;选取颈动脉血管狭窄≥70%的缺血性脑卒中患者76例作为B组,未经CAS治疗;选取血管狭窄程度<50%的缺血性脑卒中患者80例作为C组。应用3.0 T Philips磁共振成像(magnetic resonance imaging,MRI)行磁敏感加权成像(susceptibility weighted imaging,SWI)扫描,计数6个月及12个月时新增CMBs数目。结果 6个月时,A组新增8个CMBs(11.94%),B组新增19个CMBs(25.00%),C新增7个CMBs(8.75%),A组与B组、B组与C组比较差异均有统计学意义(P<0.05)。12个月时,A组新增11个CMBs(16.42%),B组新增24个CMBs(31.58%),C组新增10个(12.50%),A组与B组、B组与C组比较差异均有统计学意义(P<0.05)。结论颈动脉狭窄程度≥70%的缺血性脑卒中患者经CAS治疗后,远期新增CMBs数目能够达到血管狭窄<50%患者水平,可在一定程度上改善缺血性脑卒中患者的预后。Objective To investigate the changes of cerebral microbleeds（CBMs） after carotid angioplasty and stenting（CAS） in patients with ischemic stroke.Methods A total of 67 patients of ischemic stroke with carotid artery stenosis greater than or equal to 70% were selected as group A. All conformed to the indications of interventional therapy by digital subtraction angiography（DSA） and CAS treatments were performed. 76 patients of ischemic stroke with carotid artery stenosis greater than or equal to 70% were selected as group B and were not treated with CAS. 80 patients with ischemic stroke with carotid artery stenosis less than 50% were selected as group C. Susceptibility weighted imaging（SWI） scanning by 3.0 T magnetic resonance imaging（MRI） was used to count the new CMBs.Results At 6 months, there were 8 new CMBs（ 11.94% ） in group A, 19 new CMBs（ 25.00% ） in group B and 7 new CMBs（ 8.75% ） in group C. The differences between group A and group B, group B and group C were significant （ P 〈 0.05）. At 12 months, the new CMBs were 11（ 16.42% ） in group A, 24（ 31.58% ） in group B and 10（ 12.50% ） in group C. There were significant statistical differences between group A and group B, group B and group C（ P 〉 0.05）.Conclusion The long-time new CMBs numbers after CAS treatment of patients with ischemic stroke whose carotid artery stenosis were greater than or equal to 70% can reach the level of patients with carotid artery stenosis less than 50%. The prognosis of patients with ischemic stroke was improved to some extent.

关 键 词：颈动脉狭窄 介入治疗 脑微出血 

分 类 号：R543.4[医药卫生—心血管疾病]