论文部分内容阅读
选择2003-02/2006-02北京天坛医院应用血管内支架成形术治疗的25例颅内外动脉狭窄的患者。患者对治疗及实验均知情同意。于颈内动脉颅内、外段以及椎、基底动脉25根狭窄的血管上放置25枚支架,术后6～12个月复查数字减影血管造影,评估血管再狭窄情况。采用高效液相色谱分析术前、术后3d和造影复查时血浆同型半胱氨酸水平。术后随访6～12个月时12例(48%)出现了再狭窄,其中6例再狭窄超过50%,余6例再狭窄10%～30%。另外13例血管未发现明显再狭窄。术前两组血浆同型半胱氨酸水平比较差别无显著性意义(P>0.05);支架置入后3d两组血浆同型半胱氨酸水平均高于术前(P<0.01);6～12个月复查时再狭窄组的患者血浆同型半胱氨酸水平高于未狭窄组,差别有显著性意义(P<0.05)。结果提示支架置入后血浆同型半胱氨酸水平增高可能与术后再狭窄有关。
Twenty-five patients with intracranial and extracranial arterial stenosis underwent endovascular stenting in Beijing Tiantan Hospital from February 2003 to February 2006. Patient informed consent for treatment and experiment. Twenty-five scaffolds were placed on the 25 stenotic vessels of the internal carotid artery, the external segment, and the vertebral and basilar arteries. Digital subtraction angiography was performed 6 to 12 months after surgery to assess restenosis. The levels of plasma homocysteine in preoperative, postoperative 3d and contrast-enhanced MRI were analyzed by high performance liquid chromatography. Restenosis occurred in 12 cases (48%) 6 to 12 months after operation. Among them, 6 cases had more than 50% restenosis and 10% ~ 30% restenosis in 6 cases. Another 13 cases of blood vessels found no significant restenosis. There was no significant difference in plasma homocysteine levels between the two groups before operation (P> 0.05). Plasma homocysteine levels in the two groups were significantly higher than those before operation (P <0.01) The level of homocysteine in patients with restenosis was significantly higher than that in patients without stenosis at 12 months (P <0.05). The results suggest that elevated plasma homocysteine level may be related to restenosis after stent implantation.