摘要
目的比较支架置入术(CAS)对不同年龄段颈动脉狭窄患者血流动力学的影响。方法回顾性分析2015年6月~2017年6月在海南医学院第二附属医院神经内科住院接受CAS治疗的50例患者的临床资料,按年龄分为3组:中年组(<60岁)20例,老年组(60~<80岁)18例,高龄组(≥80岁)12例。采用彩色多普勒影像(CDFI)联合经颅多普勒超声(TCD)测量各组CAS治疗前后颈动脉狭窄局部管径(D)、狭窄段收缩期峰值流速(PSV)、血管阻力指数(RI)及患侧大脑中动脉收缩期峰值流速(PSV)、血管搏动指数(PI)、脑血管反应性(CVR),将术前及术后1周指标进行对比,并比较不同年龄组手术前后血流动力学变化程度。结果颈动脉狭窄患者行CAS术后,原狭窄处内径明显增宽,PSV、RI较术前明显降低(P<0.05),患侧MCA的PSV、PI较术前升高,CVR明显改善(P<0.05)。此外,中年组患者术后血流动力学改善最为明显,与老年组、高龄组比较,差异有统计学意义(P<0.05),中年与老年组比较,差异无统计学意义(P>0.05)。结论 CAS在各年龄段治疗颈动脉狭窄都是有效的,但<60岁组患者血流动力学改善明显。
Objective To compare the changes in cerebral hemodynamics after carotid artery stenting （CAS） at different ages. Methods A retrospective analysis of clinical date of 50 patients who had been received carotid artery stenting in the Department of Neurology of the Second Affiliated Hospital of Hainan Medical University from June 2015 to June 2017. The patients were divided into three groups according to the age： middle age-group（〈 60 years old, n = 20）, older age-group （60-〈 80 years old, n = 68）, and advanced age-group （/〉 80 years old, n = 12）. Color Doppler imaging （CD- FI） combined with transcranial Doppler ultrasound （TCD） was used to measure the local dianleter of the narrow place of posterior carotid artery （D）, the peak systolic velocity （PSV） of the narrow place, vascular resistance index （RI）, the systolic peak velocity of the middle cerebral artery （PSV） in the affected side, the vascular pulsation index （PI） and cerebrovascular reactivity （CVR） before and 1 week afier CAS, and then all these data were compared before and afier operation at different ages. Results Afier the carotid artery stenting, the diameter of the original stenosis was significantly increased, and the levels of PSV and RI were significantly decreased （P 〈 0.05）. The PSV and PI of the MCA in the affected side were higher than those before operation, and CVR was significantly improved （P 〈 0.05）. Among the three groups, there was the most significant improvement of cerebral hemodynamics in middle age-group（P 〈 0.05）. However, the changes in cerebral hemodynamics in older age-group was not significantly improved when compared with advanced age-group（P 〉0.05）. Conclusion CAS is an effective treatment in carotid artery stenosis in all the patients. Furthermore, the patients whose age 〈 60 years old have the most significant improvement in cerebral hemodynamics.
作者
代鸣明
苏庆杰
于航
龙发青
吴映曼
王德生
王布飞
高畅
DAIMingming;SUQingjie;YUHang;LONGFaqing;WUYingman;WANGDesheng;WANGBufei;GAOChang(Department of Neurology,the Second Affiliated Hospital of Hainan Medical University,Hainan Province,Haikou 570311,China;Department of Critical Care Medicine,the Second Affiliated Hospital of Hainan Medical University,Hainan Province,Haikou 570311,China;Department of Pathophysiology,Hainan Medical University,Hainan Province,Haikou 570311,China)
出处
《中国医药导报》
CAS
2018年第26期58-61,共4页
China Medical Herald
基金
国家自然科学基金资助项目(81660270)
海南省卫计委行业科研项目(1601032054A2001)
海南省高等学校科学研究(Hnky2018-50)
