颈动脉支架植入术后缺血性脑卒中患者脑组织灌注神经影像学及相关因子变化  

Changes in cerebral tissue perfusion,neuroimaging,and related factors in ischemic stroke patients after carotid artery stenting

作　　者：李致文 许英冬 魏玉清 LI Zhiwen;XU Yingdong;WEI Yuqing(Xingtai Third Hospital,Xingtai 054000,China)

机构地区：[1]邢台市第三医院,河北邢台054000

出　　处：《中国实用神经疾病杂志》2024年第7期878-882,共5页Chinese Journal of Practical Nervous Diseases

基　　金：邢台市科技计划项目(编号:2019ZC118)。

摘　　要：目的探究颈动脉支架植入术(CAS)后缺血性脑卒中患者脑组织灌注、神经影像学及相关因子变化。方法选取2021-01—2022-12邢台市第三医院收治的80例缺血性脑卒中患者为研究对象,分为CAS组和颈动脉内膜剥脱术(CEA)组各40例,对比2组患者治疗前后脑组织灌注情况[峰值时间(TTP)、平均通过时间(MTT)、脑血流量(CBF)、脑血容量(CBV)]、颈动脉狭窄及血管内皮生长因子(VEGF)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)等情况。结果治疗后2组患者TTP、MTT均降低,CBF、CBV均升高,CAS组较CEA组变化更显著(P<0.05)。治疗后2组患者颈动脉狭窄处血管内径测量结果均较治疗前增加,CAS组较CEA组变化更为显著(P<0.05)。治疗后2组患者VEGF、hs-CRP、TNF-α、IL-6水平均呈先升高后降低的趋势,治疗后1 d及7 d CEA组患者VEGF、hs-CRP、TNF-α、IL-6水平均高于CAS组(P<0.05)。结论CAS可改善缺血性脑卒中患者术后脑组织灌注及颈动脉狭窄处血管内径,对患者的相关因子水平影响较小,具有较好的治疗效果。Objective To investigate the changes of cerebral tissue perfusion,neuroimaging and related factors in patients with ischemic stroke after carotid artery stenting(CAS).Methods Eighty patients with ischemic stroke admitted to Xingtai Third Hospital from January 2021 to December 2022 were selected as the research subjects.They were divided into CAS group and carotid endarterectomy(CEA)group,with 40 patients in each group.The cerebral perfusion conditions peak time(TTP),mean transit time(MTT),cerebral blood flow(CBF),cerebral blood volume(CBV),carotid artery stenosis,the changes of vascular endothelial growth factor(VEGF),hypersensitive C-reactive protein(hs-CRP),tumor necrosis factorα(TNF-α),and interleukin-6(IL-6)before and after treatment were compared between the two groups.Results After treatment,TTP and MTT decreased,while CBF and CBV increased in both groups,and the changes in CAS group were more significant than those in CEA group(P<0.05).After treatment,the measurement results of carotid artery stenosis vessel diameter in both groups of patients increased compared to before treatment,and the CAS group showed more significant changes compared to the CEA group(P<0.05).After treatment,the levels of VEGF,hs-CRP,TNF-α and IL-6 in both groups showed a trend of first increasing and then decreasing,and the levels of VEGF,hs-CRP,TNF-αand IL-6 in CEA group were higher than those in CAS group 1 day and 7 days after treatment(P<0.05).Conclusion CAS can improve the perfusion of brain tissue and the internal diameter of carotid artery stenosis in patients with ischemic stroke after surgery,and has little influence on the level of related factors in patients,so it has a good therapeutic effect.

关 键 词：缺血性脑卒中 颈动脉狭窄 颈动脉支架植入术 脑组织灌注 神经影像学 细胞因子 

分 类 号：R743.33[医药卫生—神经病学与精神病学]