症状性大脑中动脉粥样硬化性狭窄支架植入术后血流动力学研究

发布时间：2018-08-09 19:42

【摘要】：目的探讨症状性大脑中动脉粥样硬化性狭窄患者接受颅内支架植入术前后脑血流动力学变化。方法回顾成功实施颅内支架植入术的39例症状性大脑中动脉粥样硬化性狭窄患者基线资料,对采用经颅多普勒超声检测术前、术后1周、术后3个月大脑中动脉狭窄段收缩期峰值流速(PSV)和脉动指数(PI)进行分析,比较手术前后病变血管血流动力学变化。结果 39例患者中1例术后狭窄改善不明显,38例动脉平均管径狭窄率由治疗前(80.3±8.5)%改善为术后即刻(16.3±9.2)%(P=0.011)。术后1周、术后3个月大脑中动脉狭窄段PSV与术前比较有明显降低(P=0.023),PI也较术前明显降低(P=0.028)。术后3个月时2例患者平均PSV回复升高31%~39%;术后3个月与术后1周比较,平均PSV略有升高(P=0.129),PI稍有增高(P=0.115),但差异无统计学意义。结论症状性大脑中动脉粥样硬化性狭窄患者接受颅内支架植入术后短期内脑血流得到有效增加,长期血流改善程度有待观察。
[Abstract]:Objective to investigate the changes of cerebral hemodynamics before and after intracranial stenting in patients with symptomatic middle cerebral atherosclerotic stenosis. Methods the baseline data of 39 patients with symptomatic middle cerebral artery atherosclerotic stenosis who were successfully implanted with intracranial stents were reviewed. Transcranial Doppler ultrasound was used to detect the data before operation and 1 week after operation. The peak systolic velocity (PSV) and pulsation index (PI) of middle cerebral artery stenosis were analyzed 3 months after operation to compare the hemodynamic changes before and after operation. Results the mean arterial diameter stenosis rate of 38 patients was improved from (80.3 卤8.5)% before treatment to (16.3 卤9.2)% immediately after operation (P0. 011). 1 week after operation and 3 months after operation, the PSV of middle cerebral artery stenosis was significantly lower (P0. 023) and Pi was significantly lower than that of preoperative (P0. 028). At 3 months after operation, the average PSV of 2 patients was increased by 31 / 39, and the average PSV was slightly increased (P < 0. 129) and Pi was slightly higher than that of 1 week after operation (P = 0. 115), but there was no significant difference between the three months and one week after operation. Conclusion the cerebral blood flow in patients with symptomatic middle cerebral artery atherosclerotic stenosis after intracranial stenting can be effectively increased in a short period of time, and the improvement degree of long-term blood flow remains to be observed.
【作者单位】：河南省安阳市人民医院神经内科;郑州大学人民医院介入科;
【分类号】：R743.3

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