颈动脉超声和经颅多普勒超声联合评价颈动脉狭窄支架治疗的临床价值

发布时间：2018-10-05 21:32

【摘要】：目的：采用颈动脉超声(carotid artery ultrasound)和经颅多普勒超声(transcranial doppler, TCD)技术联合评价和随访颈动脉狭窄患者行颈动脉支架置入术(carotid artery stenting, CAS)的治疗效果。方法：回顾分析经全脑血管造影(digital subtraction angiography, DSA)确诊具有脑缺血症状的颈动脉狭窄且接受颈动脉支架置入术治疗的患者71例,采用颈动脉超声联合经颅多普勒超声测量颈动脉支架置入术治疗前、后颈动脉狭窄局部管径、狭窄段收缩期峰值流速(peak systolic velocity, PSV)及同侧大脑中动脉(middle cerebral artery, MCA)的收缩期峰值流速、搏动指数(pulsatility index, PI),并进行对比分析。结果：颈动脉狭窄患者行颈动脉支架置入术后原狭窄处内径由术前(3.13±0.83)mm增加至术后1周的(4.77±0.51)mm(P0.05)、术后1年的(4.64±0.52)mm(P0.05)；颈动脉狭窄处收缩期峰值流速由术前(190.69±113.65)cm/s,降至术后1周的(86.15±30.52)cm/s(P0.05)、术后1年的(90.28±29.79)cm/s(P0.05);患侧MCA的收缩期峰值流速由术前(77.68±14.66)cm/s,术后1周升高为(115.62±22.32)cm/s(P0.05),术后1年升高为(108.89±20.29)cm/s(P0.05),PI值由术前0.81±0.01,术后1周提高到1.07±0.01(P0.05)、术后1年提高到1.06±0.02(P0.05)。结论：颈动脉超声和经颅多普勒超声检测结果提示颈动脉支架置入术后,颈动脉血管内径及脑血流动力学有明显改善,颈动脉超声和经颅多普勒超声联合可以作为准确评价和随访颈动脉支架置入术疗效的有效手段。
[Abstract]:Objective: to evaluate and follow up the therapeutic effect of carotid artery stenting (carotid artery stenting, CAS) by carotid (carotid artery ultrasound) and transcranial Doppler ultrasound (transcranial doppler, TCD) in patients with carotid artery stenosis. Methods: 71 patients with carotid artery stenosis diagnosed by (digital subtraction angiography, DSA) with cerebral ischemia and treated by carotid stenting were retrospectively analyzed. Carotid artery ultrasound combined with transcranial Doppler ultrasound was used to measure the local diameter, peak systolic velocity (peak systolic velocity, PSV) of the stenosis segment and peak systolic velocity (middle cerebral artery, MCA) of the ipsilateral middle cerebral artery (MCA) before and after carotid stenting. Pulsatility index (pulsatility index, PI),) was compared and analyzed. Results: the internal diameter of the original stenosis increased from (3.13 卤0. 83) mm to (4. 77 卤0. 51) mm () in 1 week and (4. 64 卤0. 52) mm () in 1 year after carotid artery stenosis. The peak systolic velocity of carotid artery stenosis decreased from (190.69 卤113.65) cm/s, before operation to (86.15 卤30.52) cm/s at 1 week after operation and (90.28 卤29.79) cm/s at 1 year after operation (P0.05), and the peak systolic velocity of MCA on the affected side increased from (77.68 卤14.66) cm/s, to (115.62 卤22.32) cm/s (P0.05), and 1 year after operation to (108.89 卤20.29) cm/s (P0.05). Weeks increased to 1.07 卤0.01 (P0.05), and 1 year after operation to 1.06 卤0.02 (P0.05). Conclusion: carotid artery diameter and cerebral hemodynamics were significantly improved after carotid stent implantation by carotid ultrasound and transcranial Doppler ultrasound. The combination of carotid ultrasound and transcranial Doppler ultrasound can be used as an effective method to evaluate and follow up the outcome of carotid stenting.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R743.3

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