鼻咽癌放疗后颈动脉损伤及其与放射性脑病的关系
发布时间：2019-04-16 08:48
【摘要】：背景与目的： 由于放射治疗技术的进步和综合治疗的采用，鼻咽癌的治疗效果有了一定的提高。放射性脑病、颈动脉损伤等各种并发症的发生率随之升高。本研究就鼻咽癌患者放疗后颈动脉损伤的各影响因素及颈动脉狭窄与放射性脑病的关系进行探讨。 方法： 将2011年1月至2012年2月随诊的113例接受过放疗的鼻咽癌患者作为实验组，并将29例初治诊断为鼻咽癌而未接受放疗的患者作为对照组。采用彩色多普勒超声观察患者颈部动脉损伤情况，同时进行血糖、血脂及磁共振检查，收集高血压、吸烟、心脑血管事件等各因素资料。 结果： 两组患者基本临床资料无显著差异。实验组颈动脉损伤的发生率为50/113（44.25%），，显著高于对照组的6/29（20.69%）（P=0.021）。颈内、颈总动脉损伤较对照组更常见（P分别为0.026，0.046）。颈动脉狭窄≥50%仅见于实验组（9.73%：0%），但两组无显著差异。Logistic多因素回归分析发现放疗间隔时间（5年）、年龄（50岁）是颈动脉损伤和狭窄≥50%的独立危险因素。放疗5年以上患者的颈动脉、颈总动脉狭窄发生率显著高于对照组。反复排除偏倚因素进行分析，颈动脉狭窄≥50%与放射性脑病的相关性尚不明确。 结论： 鼻咽癌放疗可导致颈动脉损伤，而且损伤多见于颈内、颈总动脉。颈动脉损伤可能开始于放疗后的3至5年。年龄50岁、放疗间隔5年以上是颈动脉损伤和狭窄的独立危险因素。颈动脉狭窄≥50%与放射性脑病的相关性需要进一步研究。鼻咽癌放疗长期生存的患者行颈部血管彩超筛查是有必要的。
[Abstract]:Background & objective: the therapeutic effect of nasopharyngeal carcinoma (NPC) has been improved due to the progress of radiotherapy technology and the use of comprehensive therapy. The incidence of radiation encephalopathy, carotid artery injury and other complications increased. In this study, the influence factors of carotid artery injury after radiotherapy and the relationship between carotid stenosis and radiation encephalopathy in patients with nasopharyngeal carcinoma (NPC) were studied. Methods: 113 NPC patients who received radiotherapy from January 2011 to February 2012 were selected as the experimental group and 29 newly diagnosed NPC patients without radiotherapy as the control group. The cervical artery injury was observed by color Doppler ultrasound, blood glucose, blood lipid and magnetic resonance imaging (MRI) were performed. The data of hypertension, smoking, cardio-cerebral vascular events and other factors were collected. Results: there was no significant difference in the basic clinical data between the two groups. The incidence of carotid artery injury in the experimental group was 50% (44.25%), which was significantly higher than that in the control group (6 / 29 (20.69%) (P < 0.021). The common carotid artery injury was more common in the internal neck than that in the control group (P = 0.026, P = 0.046, respectively). Carotid stenosis 鈮
本文编号：2458644
[Abstract]:Background & objective: the therapeutic effect of nasopharyngeal carcinoma (NPC) has been improved due to the progress of radiotherapy technology and the use of comprehensive therapy. The incidence of radiation encephalopathy, carotid artery injury and other complications increased. In this study, the influence factors of carotid artery injury after radiotherapy and the relationship between carotid stenosis and radiation encephalopathy in patients with nasopharyngeal carcinoma (NPC) were studied. Methods: 113 NPC patients who received radiotherapy from January 2011 to February 2012 were selected as the experimental group and 29 newly diagnosed NPC patients without radiotherapy as the control group. The cervical artery injury was observed by color Doppler ultrasound, blood glucose, blood lipid and magnetic resonance imaging (MRI) were performed. The data of hypertension, smoking, cardio-cerebral vascular events and other factors were collected. Results: there was no significant difference in the basic clinical data between the two groups. The incidence of carotid artery injury in the experimental group was 50% (44.25%), which was significantly higher than that in the control group (6 / 29 (20.69%) (P < 0.021). The common carotid artery injury was more common in the internal neck than that in the control group (P = 0.026, P = 0.046, respectively). Carotid stenosis 鈮
本文编号：2458644
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