《中国康复理论与实践》

《中国康复理论与实践》 ›› 2009, Vol. 15 ›› Issue (04): 352-354.

• 临床研究 • 上一篇    下一篇

颅内外动脉狭窄患者血管内支架成形术围术期及随访期间血浆炎性因子表达与意义

高连波1;刘一娜2   

  1. 1. 中国医科大学附属第四医院神经内科，辽宁沈阳市 110032;2. 中国医科大学2007级研究生，辽宁沈阳市 110001
  • 收稿日期:2008-12-15 修回日期:2009-03-17 出版日期:2009-04-01 发布日期:2009-04-01

Expression and Significance of Plasmic Inflammatory Factor during Perioperative and Follow-up Periods after Endovascular Stents in Patients with Cerebral Arterial Stenosis

GAO Lian-bo, LIU Yi-na   

  1. The Department of Neurology, the Fourth Hospital Affiliated to China Medical University, Shenyang 110032, Liaoning, China
  • Received:2008-12-15 Revised:2009-03-17 Published:2009-04-01 Online:2009-04-01

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摘要： 目的 观察颅内外动脉狭窄患者接受血管内支架成形术围术期及随访期间血浆炎性因子的表达与意义。方法 选择经数字减影血管造影(DSA)证实颈内颅内外动脉狭窄患者54例为支架治疗组，分别行血管内支架成形术，另有32例同期住院未接受支架术治疗的同病患者为对照组，分别检测两组患者围术期不同时间点及随访期间血浆白细胞介素6（IL-6）和高敏C反应蛋白（hs-CRP）水平。采样时间A期代表造影或导管插入前1 d，B期代表术后6 h(支架治疗组)或诊断性造影后6 h(对照组)，C～I期分别代表支架治疗组支架置入后12 h、24 h、48 h、72 h、1个月和6个月或对照组造影后相同时段。结果 两组患者A期hs-CRP和IL-6水平分布接近（均 P>0.05），支架治疗组B～I期采样时间点血浆hs-CRP和IL-6水平均高于A期和对照组同期（ P<0.05～0.01）。支架治疗组患者术后6个月经影像学检查证实发生再狭窄患者21例（38.89%），其血浆hs-CRP和IL-6水平分布A～F期与支架术后无再狭窄患者接近（均 P>0.05），但G期和I期均高于后者（均 P<0.05～0.01）。结论 血管内支架成形术可导致颅内外动脉狭窄患者围术期血浆IL-6和hs-CRP水平增高，而且上述指标随访期间高表达是支架术后再狭窄的危险因素。

关键词: 颅内外动脉狭窄, 血管内支架成形术, 围术期/随访, 白细胞介素-6, 高敏C反应蛋白

Abstract: Objective To observe expression and significance of inflammatory factor during perioperative and follow-up periods after endovascular stents in patients with cerebral arterial stenosis.Methods 54 patients diagnosed as cerebral arterial stenosis by digital substraction angiography (DSA) were selected as the stent group and treated with endovascular stents; another 32 subjects had the same disease but not accepted stenting were considered as the control group. Interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hs-CRP) contents were measured at different time points during perioperative and follow-up periods in the two groups. Stage A represented as day one before angiography or catheterization; stage B as 6 hours postoperatively (stent group) or 6 hours after diagnostic angiography (control group); stages C～I as 12, 24, 48, 72 hours, 1 and 6 months after stent insertion (stent group) or the same time points after angiography (control group).Results Contents of IL-6 and hs-CRP of the stent group were similar as the control group in the stage A ( P>0.05), but significantly higher than that of the control group during stages B～I ( P<0.01～0.05). Among 54 patients of the stent group, 21 cases had restenosis 6 months postoperatively (38.89%). Contents of IL-6 and hs-CRP of the patients were similar as those without restenosis in stages A～F postoperatively ( P>0.05), but significantly higher than that of the cases without restenosis in stages G and I postoperatively ( P<0.01～0.05).Conclusion Endovascular stents can increase the contents of IL-6 and hs-CRP of patients with cerebral arterial stenosis; in addition, high expression of them is the risk factor of post-stent restenosis during follow-up period.

Key words: cerebral arterial stenosis, endovascular stents, perioperative period/follow-up period, interleukin-6, high-sensitivity C-reactive protein