摘要
目的探讨血管内支架成形术治疗老年缺血性脑血管病(ICVD)的疗效及对患者血管内皮功能和并发症的影响。方法选取2017年1月~2018年12月于我院就诊的老年缺血性脑血病管患者96例,随机分成观察组和对照组,各48例。对照组采用药物治疗,观察组在对照组基础上采用血管内支架成形术治疗。比较治疗前及治疗1年后两组患者病变血管血流情况、血管狭窄程度、神经缺损(NIHSS)、认知功能(MMSE),治疗前及术后1d两组患者血管内皮功能以及治疗期间两组患者并发症情况。结果治疗1年后,两组颈总动脉、颈内动脉、基底动脉、椎动脉收缩期峰流速均较治疗前降低,且观察组低于对照组(P<0.05);观察组血管狭窄程度低于对照组(P<0.05);观察组NIHSS评分低于对照组,MMES评分高于对照组(P<0.05);术后1d,观察组VEGF、NO水平低于对照组,ET-1水平高于对照组(P<0.05);治疗期间,观察组并发症发生率为6.25%,低于对照组的20.83%(P<0.05)。结论血管内支架成形术能够有效改善老年ICVD患者血管狭窄程度,改善患者神经障碍及认知功能,且并发症较少,但血管内支架成形术的机械刺激对患者血管内皮有轻微损害,因此术中应注意保护血管内皮,术后采用合适药物改善患者血管内皮功能。
Objective To explore curative effect of percutaneous transluminal angioplasty and stenting(PTAS)on the elderly with ischemic cerebrovascular disease(ICVD)and its influences on vascular endothelial function and complications.Methods A total of 96 elderly ICVD patients diagnosed in our hospital from Jan 2017 to Dec 2018 were enrolled.They were randomly divided into observation group and control group,48 cases in each group.The control group was treated with drugs,while observation group was additionally treated with PTAS.The blood flow of lesion vessels,vascular stenosis,National Institute of Health Stroke Scale(NIHSS)and Mini-Mental State Examination(MMSE)before treatment and one year after treatment,vascular endothelial function before treatment and one day after surgery,and complications during treatment were compared between the two groups.Results One year after treatment,peak systolic velocity(PSV)of common carotid artery,internal carotid artery,basilar artery and vertebral artery in both groups were lower than those before treatment,which were lower in observation group than control group(P<0.05).The vascular stenosis degree in observation group was lower than that in control group(P<0.05).NIHSS score of observation group was lower than that of control group,while MMES score was higher than that of control group(P<0.05).One day after surgery,VEGF and NO in observation group were lower than those in control group,while ET-1 was higher than that in control group(P<0.05).During treatment,incidence of complications in observation group was lower than that in control group(6.25%vs 20.83%),P<0.05.Conclusion PTAS can effectively improve vascular stenosis degree,nerve disorders and cognitive function in elderly ICVD patients with fewer complications.However,there is slight damage of PTAS mechanical stimulation to vascular endothelium.So endothelium should be protected during surgery,and appropriate drugs should be used to improve vascular endothelial function.
作者
魏志玄
Wei Zhixuan(The First Affiliated Hospital of Nanyang Medical College,Nanyang 473000)
出处
《中国现代医药杂志》
2020年第7期31-35,共5页
Modern Medicine Journal of China
