血管内支架植入术治疗缺血性脑血管病颈动脉狭窄患者的临床效果分析

Clinical effect of endovascular stent implantation in treatingcarotid artery stenosis in patients with ischemic cerebrovascular disease

  • 摘要:
    目的 观察血管内支架植入术治疗缺血性脑血管病(ICVD)颈动脉狭窄患者的临床效果。
    方法 选取行ICVD治疗的患者83例分为观察组43例和对照组40例,比较2组患者的血流动力学指标和颈内动脉血管狭窄程度、神经标志物与血管内皮功能、神经功能缺损程度、临床疗效和不良反应。
    结果 2组患者经治疗后的血管收缩期峰流速(PSV)、舒张末期流速(EDV)和血管狭窄程度均呈下降趋势,且对照组的PSV、EDV和血管狭窄程度下降幅度均小于观察组,差异有统计学意义(P < 0.05); 2组患者治疗后的正五聚蛋白-3(PTX-3)、神经元特异性烯醇化酶(NSE)均有降低,血管扩张功能(FMD)和血管内皮生长因子(VEGF)均有提升,且观察组的PTX-3、NSE低于对照组, VEGF、FMD高于对照组,差异有统计学意义(P < 0.05); 治疗后2组患者的美国国立卫生研究院脑卒中量表(NIHSS)和改良爱丁堡-斯堪的纳维亚评分(MESSS)均降低,且对照组NIHSS评分和MESSS降低幅度小于观察组; 对照组的临床总有效率为80.00%, 低于观察组的97.67%, 差异有统计学意义(P < 0.05); 观察组和对照组的不良反应发生率分别为2.33%和22.50%, 差异有统计学意义(P < 0.05)。
    结论 血管内支架植入术能够有效提高ICVD患者的临床疗效,减轻血管狭窄程度,改善患者的认知功能,且具有较高安全性。

     

    Abstract:
    Objective To observe the clinical effect of endovascular stent implantation in the treatment of patients with ischemic cerebrovascular disease (ICVD) and carotid artery stenosis.
    Methods A total of 83 patients with ICVD treatment were selected and divided into observation group with 43 cases and control group with 40 cases, and the hemodynamic indicators and degree of internal carotid artery stenosis, neural markers and vascular endothelial function, degree of neurological deficits, clinical efficacy, and adverse reactions were compared between the two groups.
    Results Peak systolic velocity (PSV), end-diastolic velocity (EDV), and degree of vascular stenosis in both groups showed a downward trend after treatment, and the declines in PSV, EDV and vascular stenosis in the control group were all significantly smaller than those in the observation group (P < 0.05). After treatment, the positive pentraxin-3 (PTX-3) and neuron-specific enolase (NSE) levels in both groups decreased significantly, while functional movement disorder (FMD) and vascular endothelial growth factor (VEGF) levels increased significantly, and the PTX-3 and NSE levels in the observation group were significantly lower than those in the control group, while the VEGF and FMD levels were significantly higher (P < 0.05). After treatment, scores of the National Institutes of Health Stroke Scale (NIHSS) and the Modified Edinburgh-Scandinavian Stroke Scale (MESSS) in both groups decreased, and the decline in NIHSS score and MESSS in the control group was smaller than that in the observation group. Clinical total effective rate was 80.00% in the control group, which was significantly lower than 97.67% in the observation group (P < 0.05). The incidence of adverse reactions in the observation group was 2.33%, which was significantly lower than 22.50% in the control group (P < 0.05).
    Conclusion Endovascular stent implantation can effectively improve the clinical efficacy of ICVD patients, relieve the degree of vascular stenosis, improve cognitive function, and has higher safety.

     

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