摘要
目的探讨颈动脉支架置入术(CAS)对脑血管反应性(CVR)的影响。方法选择行CAS治疗的59例患者作为手术组,并根据是否伴有临床症状分为无症状组1 4例和症状组45例;将症状组再分为中度狭窄组12例和重度狭窄组33例;同期选择未行CAS的缺血性脑卒中住院患者32例作为对照组。利用经颅多普勒结合CO_2吸入试验检测手术前后CVR的变化。结果与对照组比较,手术组患者手术前手术侧和手术对侧CVR明显降低,差异有统计学意义(P<0.01)。手术组患者手术前手术侧CVR明显低于手术对侧(P<0.01);术后手术侧和手术对侧CVR均显著高于手术前(P<0.01)。症状组和无症状组患者手术后手术侧CVR均显著高于手术前(P<0.01)。重度狭窄组患者手术前手术侧和手术对侧CVR均明显低于中度狭窄组(P<0.01),手术后手术对侧CVR明显低于中度狭窄组(P<0.05)。结论 CAS能有效改善颈动脉狭窄患者的CVR;经颅多普勒结合CO_2吸入试验可作为检测CVR的方法之一。
Objective To study cerebral vasoreactivity（CVR） changes after carotid stenting. Meth ods Fifty-nine patients with carotid artery stenosis who received carotid stenting（CAS） treatment were selected as the operated group. According to the clinical symptoms, the group was divided into asymptomatic group（14 cases） and symptomatic group（45 cases）. Based on the degree of stenosis,the symptomatic group was divided into moderate stenosis group（12 cases） and severe stenosis group（33 cases）. Thirty-two hospitalized stroke patients who had not received carotid stenting at the same period served as the control group. Transcranial Doppler combined with CO2 inhalation test was done to assess the changes of CVR before and after CAS. Results Compared with the control group,preoperative CVR of the operated and contralateral sides significantly reduced in the operated group,the difference was statistically side CVR was more obviously impaired than the contralatera CVR significantly increased on both the operated and contra significant （P 〈 0.01）, the operated side （P 〈 0.01）. After stenting the ateral sides （P 〈 0.01）. Postoperative CVR of the operated side in both asymptomatic and symptomatic groups significantly improved compared with before operation. The CVR changed significantly on both sides after surgery in the severe stenosis group （P 〈 0.01）, compared with the moderate stenosis group. The preoperative CVR on both sides in severe stenosis group was lower than that in moderate stenosis group （P 〈 0.01）, the CVR of contralateral side after surgery was still lower than that in the moderate stenosis group （P 〈 0. 05）. Conclusions CAS can significantly improve compromised cerebral vasoreactivity on both the operated and contralateral sides〈TCD combined with CO2 inhalation test is a method for detecting CVR.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2010年第10期895-898,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
支架
血管成形术
脑血管循环
颈动脉狭窄
超声检查
多普勒
经颅
stents
angioplasty
cerebrovascular circulation
carotid stenosis
ultrasonography, Doppler, transcranial
