摘要
目的:探讨颈动脉支架置入术(CAS)治疗颅外颈动脉狭窄患者的近期疗效,并观察其对患者凝血功能及炎症反应的影响。方法:收集2014年6月至2016年5月在江苏省淮安市淮阴医院神经内科行CAS的颅外颈动脉狭窄患者68例。对比治疗前、后患者的病变处动脉狭窄程度,记录手术成功率;应用彩色多普勒超声仪测定狭窄处颈动脉血流参数水平;应用凝血仪测定血浆中凝血指标水平,酶联免疫吸附法测定血清中炎症因子白介素-6(IL-6)、白介素-8(IL-8)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)的含量。结果:术后3d,颅外颈动脉狭窄患者病变部位动脉狭窄程度显著低于术前(P<0.05),且手术成功率达100%。颅外颈动脉狭窄患者的颈动脉血流参数收缩期峰值流速(PSV)、舒张期最低血流速度(EDV)、阻力指数(RI)水平低于术前,搏动指数(PI)水平高于术前(均P<0.05)。与术前比较,患者术后凝血酶原时间(PT)和活化部分凝血活酶时间(APTT)均显著缩短,D-二聚体(D-D)、纤维蛋白原(FIB)、IL-6、IL-8、hs-CRP及TNF-α水平均显著升高(均P<0.05)。结论:CAS治疗颅外颈动脉狭窄患者效果确切,但可引起患者术后早期出现高凝状态及炎症反应。
Objective： To study the short-term efficacy of carotid artery stenting （CAS） for extracranial carotid artery stenosis （ECAS） and the influence on patients’ coagulation function and inflammatory response.Methods： A total of 68 patients with ECAS who received CAS treatment in our hospital from June 2014 to to May 2016 were enrolled in this study.The extent of coronary artery stenosis and the coagulation function were observed before and after treatment.The success rate of surgery was recorded.The blood-flow parameters of carotid artery in stenosis were detected by color Doppler ultrasonography.The levels of interleukin-6 （IL-6）,interleukin-8 （IL-8）,high sensitive C-reactive protein （hs-CRP） and tumor necrosis factor-α （TNF-α） in serum were measured by enzyme-linked immunosorbent assay.Results： After 3 days of operation,the degree of arterial stenosis was significantly attenuated （ P 〈0.05）,and the success rate of the surgery was 100%.Blood-flow parameters such as peak systolic velocity （PSV）,end diastolic flow velocity （EDV） and resistance index （RI） were decreased after operation,while the pulse index （PI） was increased （ P 〈0.05）.The prothrombin time （PT） and activated partial thrombin time （APTT） after operation were notably shorter,and the levels of D-dimer （D-D）,fibrinogen （FIB）,IL-6,IL-8,hs-CRP and TNF-α after operation were higher than those before operation （ P 〈0.05）.Conclusion： CAS was effective for the treatment of ECAS,but it might cause hypercoagulability and inflammatory reaction at early post-operative period.
作者
田臻
杨扬
吴艳云
Tian Zhen;Yang Yang;Wu Yanyun(Department of Neurology,Huaiyin Hospital of Huai＇an City,Huai＇an 223300,China)
出处
《广西医科大学学报》
CAS
2018年第9期1249-1252,共4页
Journal of Guangxi Medical University
关键词
颅外颈动脉狭窄
颈动脉支架置入术
凝血功能
炎症反应
extracranial carotid artery stenosis
carotid artery stenting
coagulation function
inflammatory response
