摘要
目的 探讨短暂性脑缺血发作（TIA）患者行颈动脉支架置入术（CAS）前后白介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）的水平变化及其与再狭窄的关系.方法 根据病变情况、手术复杂程度将67例TIA患者分为A组（单支单处病变,置入1个支架,处理1处病变,38例）和B组（单支弥漫性病变或多支多处病变,置入2个支架,处理2处病变,29例）,术后1年常规进行头颈血管CTA检查,并根据结果分为再狭窄组（14例）和无狭窄组（48例）.检测患者在CAS术前,术后1 h、2周、1个月、6个月、1年血浆IL-6、TNF-α及血清CRP水平,其中CRP检测采用免疫透射比浊法,IL-6、TNF-α检测采用放射免疫测定法.结果随访中1例死亡,4例失访,有14例存在不同程度的狭窄,其中3例再狭窄≥50%.与术前比较,术后1 h、2周、6个月CRP、IL-6水平明显升高,术后1 h、2周、1个月、6个月TNE-α水平明显升高,差异均有统计学意义（P〈0.05）.与A组比较,B组术后1 h、2周、6个月CRP水平明显升高,术后1 h、2周、1年TNF-α水平明显升高,差异均有统计学意义（P〈0.05）.与无狭窄组比较,再狭窄组术后1 h、2周、6个月CRP水平明显升高,术后1 h、2周、1个月、6个月IL-6水平明显升高,术后各时间点TNF-α水平明显升高,差异均有统计学意义（P〈0.05）.结论 IL-6、TNF-α、CRP在CAS后迅速升高,之后逐渐回落,在术后6个月再次出现升高,尤以再狭窄者为著,其可作为预测早期再狭窄的参考指标.
Objective To explore the changes of the levels of lnterleukin-6 （IL-6）, tumor necrosis factor α （TNF-α and c-reactive protein （CRP） after carotid artery stenting （CAS） and their relation to restenosis in patients with transient ischemic attack. Methods The patients were divided into group A （with 1 stenting and 1 lesion, n-38） and group B （with 2 stenting and 2 lesions, n=29） according to the pathologic changes and complicated degrees of CAS, and all the patients were divided into restenosis group （n=14） and non-restenosis group （n=48） according to the examination results of cervical CTA 1 y after CAS. The levels of IL-6, TNF-α and CRP were measured before CAS and 1 h, 2 w, 1 and 6 mon, and 1 y after stents. The level of CRP was measured by enhanced immunoturbidimetic assay, and the levels of IL-6 and TNF-α were measured by radioimmunoassay. Results In the follow-up survey, 1 died and 4 were lost. Fourteen had restenosis of different degrees. The restenosis rate more than 50 percent was noted in 3 patients. Compared to those before CAS, the levels of CRP, 1L-6 and TNF-α were increased rapidly after CAS （P〈0.05）. Compared to those in the group A, the levels of CRP, IL-6 and TNF-α in the group B 1 h, 2 w and 6 mon alter CAS were obviously increased （P〈0.05）. Compared to those in the non-restenosis group, the levels ofCRP, 1L-6 and TNF-α in the restenosis group 1 h, 2 w and 6 mon after CAS were obviously increased （P〈0.05）. Conclusion The levels of IL-6, TNF-α and CRP increased rapidly after CAS, then reduced gradually and increased once again 6 months after CAS, which was notable in restenosis group. They can be the reference indexes of the forecast for early restenosis.
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2010年第7期657-661,共5页
Chinese Journal of Neuromedicine
基金
“十一五”国家科技支撑计划（2006BA101A11）子课题
