颅外颈动脉血流动力学超声分析在预测老年颅内动脉狭窄中的价值

发布时间：2018-03-16 21:25

本文选题：颅外颈动脉　切入点：血流动力学　出处：《中国老年学杂志》2017年17期 　论文类型：期刊论文

【摘要】：目的探讨颅外颈动脉血流动力学改变对预测老年颅内动脉狭窄的价值及免疫学机制。方法选取2016年1~6月确诊为颅内动脉中、重度狭窄的老年患者92例为研究组;同期收治的无脑血管病或仅存在轻度脑动脉硬化的老年患者42例为对照组,用超声检查两组颅外颈动脉血流动力学参数。收集两组静脉血分离外周血单个核细胞(PBMC),流式细胞术检测Th1、Th2、Th17细胞比例。结果研究组颅内前循环狭窄患者PSV颈总动脉(CCA)、EDVCCA、PSVICA、EDVICA、PSVICA/PSVCCA均明显低于对照组,RIVCCA、RIICA明显高于对照组(P0.05);EDVCCA、PSVICA、RIVCCA、EDVICA预测颅内前循环狭窄的准确性较高。研究组后循环狭窄患者PSVVA、EDVVA、MPSVVA、MEDVVA均明显低于对照组,RIVA、MRIVA明显高于对照组(P0.05);PSVVA、EDVVA、RIVA预测颅内后循环狭窄的准确性较高。研究组PBMC中Th1、Th17细胞比例明显高于对照组(P0.01);两组Th2细胞比例差异无统计学意义(P0.05);研究组颈动脉重度狭窄患者PBMC中Th1、Th17细胞比例明显高于中度狭窄者(P0.05)。结论超声分析颈动脉血流动力学参数可有效预测颅内前、后动脉狭窄;Th1与Th17细胞介导的免疫机制参与颅内动脉狭窄的发生、发展过程。
[Abstract]:Objective to investigate the value and immunological mechanism of extracranial carotid artery hemodynamic changes in predicting intracranial artery stenosis in the elderly. Methods 92 elderly patients with severe stenosis from 2016 to June were selected as the study group. 42 elderly patients with no cerebrovascular disease or only mild cerebral arteriosclerosis were treated as control group. The hemodynamic parameters of extracranial carotid artery were examined by ultrasound. Peripheral blood mononuclear cells were isolated from peripheral blood mononuclear cells (PBMC) in both groups, and Th1 Th2Th2Th17 cells were detected by flow cytometry. Results the common carotid artery of PSV in patients with intracranial anterior circulation stenosis was detected by flow cytometry. The accuracy of predicting intracranial anterior circulation stenosis in patients with posterior circulation stenosis in the study group was significantly lower than that in the control group (P < 0.05). The prediction of intracranial anterior circulation stenosis in the study group was significantly lower than that in the control group (P < 0.05). The prediction of intracranial anterior circulation stenosis in the study group was significantly lower than that in the control group (P < 0.05), and the prediction of posterior circulation stenosis in the study group was significantly lower than that in the control group (P < 0.05). The prediction of intracranial posterior circulation stenosis in the study group was significantly lower than that in the control group (P < 0.05), and it was significantly higher in the study group than that in the control group (P < 0.05). The prediction of intracranial anterior circulation stenosis in the study group was significantly lower than that in the control group (P 0.05). The prediction of intracranial posterior circulation stenosis in the study group was significantly lower than that in the control group (P 0.05). The percentage of Th1 Th17 cells in PBMC in study group was significantly higher than that in control group (P 0.01), there was no significant difference in the proportion of Th2 cells between the two groups (P 0.05) and the proportion of Th1 Th17 cells in PBMC in patients with severe stenosis of carotid artery in study group was significantly higher than that in patients with moderate stenosis. Conclusion Ultrasound analysis of carotid hemodynamic parameters can effectively predict the intracranial anterior. The immune mechanism mediated by Th1 and Th17 cells is involved in the occurrence and development of intracranial artery stenosis.
【作者单位】：承德市中心医院超声诊断科;
【基金】：承德市科学技术研究与发展计划项目课题(No.20151004)
【分类号】：R445.1;R743.3

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