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目的探讨缺血性脑血管病(ICVD)介入治疗对血浆中血管内皮活性物质的影响。方法收集汉中市中心医院2012年2月至2016年4月收治的60例ICVD患者为病例组,同期健康体检者60例作为对照组,采用酶联免疫吸附法(ELISA)检测患者内皮素-1(ET-1)、一氧化氮(NO)及血管性血友病因子(v WF)水平,分析两组间及数字减影血管造影(DSA)和经皮腔内血管成形支架置入术(PTAS)治疗术间内皮活性物质差异及相关关系。用SPSS 13.0统计软件进行数据的处理。结果治疗前,病例组ET-1和v WF水平均明显高于对照组,NO水平明显低于对照组,差异均有统计学意义(P<0.05);PTAS介入治疗后1、12、24 h ET-1和v WF水平均明显高于DSA介入方法同治疗时期水平,NO水平明显低于DSA治疗同时期水平,差异均有统计学意义(P<0.05);DSA和PTAS介入治疗后1、12、24 h ET-1水平均明显高于治疗前,治疗24 h明显低于治疗后1 h,差异均有统计学意义(P<0.05);DSA治疗后1、12 h NO水平明显低于治疗前,治疗12 h明显高于治疗后1 h,治疗24 h明显高于治疗12 h,PTAS治疗后1、12、24 h NO水平均明显低于治疗前,治疗后12、24 h明显高于治疗后1 h,治疗后24 h明显高于12 h,差异均有统计学意义(P<0.05);PTAS治疗后1、12、24 h v WF水平均明显高于治疗前,治疗后12、24 h明显低于治疗后1 h,治疗后24 h明显低于治疗后12 h,差异均有统计学意义(P<0.05);NO与ET-1、v WF呈明显的负相关(r值分别为-1.231、-0.786,P<0.05),ET-1与v WF呈明显的正相关(r=0.897,P<0.05)。结论 ET-1、v WF在ICVD中高表达,NO低表达,患者经过介入治疗后会对血管内皮细胞产生一定损伤,并且支架介入损害程度较大,临床值得关注。
Objective To investigate the effect of interventional therapy of ischemic cerebrovascular disease (ICVD) on vascular endothelial active substances in plasma. Methods Sixty ICVD patients admitted from Hanzhong Central Hospital from February 2012 to April 2016 were selected as the case group and 60 healthy subjects were used as the control group. ELISA was used to detect endothelin-1 (ET-1), nitric oxide (NO) and von Willebrand factor (vWF) levels were compared between the two groups and between digital subtraction angiography (DSA) and percutaneous transluminal angioplasty PTAS) in the treatment of intraoperative changes of endothelial active substances and their relationship. Using SPSS 13.0 statistical software for data processing. Results Before treatment, the levels of ET-1 and vWF were significantly higher in case group than those in control group, and the levels of NO were significantly lower than those in control group (P <0.05); 1, 12, 24 h after PTAS intervention The levels of ET-1 and vWF were significantly higher than those of the DSA-interventional therapy and the levels of NO were significantly lower than those of the DSA-treated group (P <0.05). After DSA and PTAS intervention, The levels of ET-1 at 12 and 24 hours after treatment were significantly higher than those before treatment, and the levels of ET-1 at 24 and 24 hours after treatment were significantly lower than those at 1 and 12 hours after treatment (P <0.05) Before treatment, the treatment 12 h was significantly higher than 1 h after treatment, the treatment 24 h was significantly higher than the treatment 12 h, PTAS treatment 1, 12, 24 h after the NO levels were significantly lower than before treatment, 12 and 24 h after treatment was significantly higher The levels of WF at 1, 12 and 24 h after PTAS treatment were significantly higher than those before and 12 and 24 h after treatment, respectively, at 1 h and 24 h after treatment (P <0.05) 24 h was significantly lower than 1 h after treatment, 24 h after treatment was significantly lower than 12 h after treatment, the difference was statistically significant (P <0.05); NO and ET-1, v WF showed a significant negative correlation (r value Respectively -1.231, -0.786, P <0. 05), ET-1 and vWF showed a significant positive correlation (r = 0.897, P <0.05). Conclusions ET-1 and vWF are highly expressed in ICVD and low in NO. After interventional therapy, ET-1 and vWF may cause some damage to vascular endothelial cells.