摘要
目的探讨颈动脉支架植入术前后脑血管反应性（cerebralvasoreactivity，CVR）的变化规律及其影响因素。方法采用经颅多普勒超声（TCD）结合屏气试验检测42例颈动脉支架植入术患者手术前1d、术后1～2d双侧大脑中动脉的屏气指数（breath—holdingindex，BHI）。采用配对t检验分析支架植入术前后BHI的变化规律，并采用多元回归法分析术后BHI升高的相关因素。结果42例患者术后手术侧BHI均较术前明显提高（术前0．63±0．20，术后1．014-0．10，f=一14．28P=0．00），且无症状组（术前0．77±0．09，术后1．06±0．18，f=一16．74，P=0．00）、症状组（术前0．51±0．19，术后0．97±0．09，t=-11．18，P=0．00）患者手术前后差异均有统计学意义，非手术侧术后BHI虽较前增加，但差异无统计学意义。术后BHI的提高幅度与术前BHI呈负相关（β=-1．00，P=0．00），与术后BHI呈正相关（β=1．00，P=0．00）。结论颈动脉支架植入术能明显改善狭窄侧的CVR，改善程度与手术前和术后BHI有关。
Objective To evaluate cerebral vasoreactivity before and after carotid angioplasty and stenting in patients with symptomatic and asymptomatic carotid stenosis. Methods Forty-two patients with carotid stenosis （19 symptomatic, 23 asymptomatic） were examined on Transcranial Doppler and the breath- holding index （BHI） after hypercapnia was used to assess the changes of cerebral vasoreactivity before and 1 or 2 days after stenting procedure. The change of BHI was analyzed by using paired t test before and after procedures. Muhivariable regression was used to detect influential factors for the BHI enhancement. Results After stenting, the BHI significantly increased on the previously stenotic side： in asymptomatic group, preoperative BHI 0. 77 ± 0. 09, postoperative BHI 1.06 ± O. 18, t = - 16. 74, P = O. 00 ; in symptomatic group, preoperative BHI 0. 51 ± 0. 19, postoperative BHI 0. 97 ± 0. 09, t = - 11.18, P = 0.00, and slightly increased on the contralateral side. The change of cerebral vasoreactivity had a negative correlation with the preoperative BHI. Conclusions Carotid angioplasty and stenting can significantly improve compromised cerebral vasocular reactivity on the stenting treated side.
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2010年第4期261-264,共4页
Chinese Journal of Neurology
基金
基金项目：南京军区十一五重点课题资助项目（082026）
南京市科技计划资助项目（200702066）
