Effect of stent implantation on recanalization and nerve biochemical in patients with carotid artery stenosis

doi:10.3969/j.issn.1009-976X.2020.06.011

Abstract

Abstract: Objective To study the effect of stent implantation on recanalization and nerve cell biochemical in patients with carotid artery stenosis. Methods A total of 61 patients with carotid artery stenosis admitted to our hospital from January 2016 to January 2020 were selected and numbered by visiting sequence. SPSS22.0 software was applied to generate a random number table, and patients were into surgical intervention group and control group, consisting of experimental group （n=30） and control group （n=31） by random number table. The control group received internal medicine surgery of routine carotid artery stenosis; the experimental group received stent implantation. The two groups of patients were compared before treatment and four weeks after treatment in terms of nerve cell biochemicals [central nervous system specific protein （S100β）, human brain myelin basic protein （MBP）, neuron specific enolase （NSE）], oxidative stress factor [superoxide dismutase （SOD）, malondialdehyde （MDA）], and cognitive function assessment. The adverse reactions of the two groups of patients during treatment and the vascular patency of the two groups of patients after 3 and 6 months of treatment were compared. Results After treatment, compared with the control group, S100β, MBP, NSE were significantly lower in the experimental group （P< 0.05）. After treatment, compared with the control group, the experimental group had significantly higher SOD and significantly lower MDA （P> 0.05）. After treatment, the MOCA score of the experimental group was significantly higher than that of the control group （P< 0.05）. Conclusion Stent implantation can significantly improve the neuronal biochemicals, oxidative stress factors and cognitive function in patients, increase the rate of postoperative vascular recanalization with high safety.

Key words: carotid artery stenosis, stent implantation, vascular recanalization, nerve biochemicals, oxidative stress factor

摘要： 目的研究支架植入术对颈动脉狭窄患者血管再通及神经生化物的影响。方法选取2016年1月~2020年1月我院收治的61例颈动脉狭窄患者,将患者采用随机数字表法分为手术干预组（n=30）和对照组（n=31）,对照组接受内科常规颈动脉狭窄手术治疗;手术干预组接受支架植入术治疗。对比两组患者治疗前和治疗四周后神经生化物[中枢神经特异蛋白（S100β）、人脑髓鞘碱性蛋白（MBP）、神经元特异性烯醇化酶（NSE）]、氧化应激因子[超氧化物歧化酶（SOD）,丙二醛（MDA）]、及认知功能评估;对比两组患者治疗期间出现的不良反应;对比两组患者治疗3、6个月后血管通畅情况。结果治疗后,相比于对照组,手术干预组S100β、MBP、NSE显著更低（P<0.05）;治疗后,相比于对照组,手术干预组SOD显著更高,MDA显著更低（P<0.05）;治疗后,相比于对照组,手术干预组MOCA评分显著更高（P<0.05）。结论支架植入术能够明显改善患者神经生化物、氧化应激因子和认知功能,提高术后血管再通率,且安全性较高。

关键词: 血管再通, 氧化应激因子, 支架植入术, 颈动脉狭窄, 神经生化物

CLC Number:

R654.2

LIN Mao-hui, ZHAN Meng-xiong, ZHENG Lin-fei, LIU Sheng-ze. Effect of stent implantation on recanalization and nerve biochemical in patients with carotid artery stenosis[J]. Lingnan Modern Clinics in Surgery, 2020, 20(06): 736-740.

林茂晖, 詹梦熊, 郑霖飞, 刘盛泽. 支架植入术对颈动脉狭窄患者血管再通及神经生化标志物的影响[J]. 岭南现代临床外科, 2020, 20(06): 736-740.

References

[1] 中华医学会分会血管外科学组. 颈动脉狭窄诊治指南[J]. 中华血管外科杂志, 2017, 2(2): 78-84.
[2] Carbone F, Rigamonti F, Burger F, et al.Serum levels of osteopontin predict major adverse cardiovascular events in patients with severe carotid artery stenosis[J]. Int J Cardiol, 2018, 12(12): 195-199.
[3] Gacoń J, Badacz R, Stepień E, et al.Diagnostic and prognostic micro-RNAs in ischaemic stroke due to carotid artery stenosis and in acute coronary syndrome: a four-year prospective study[J]. Kardiol Pol, 2018, 76(2): 362-369.
[4] Yuan G, Zhou S, Wu W, et al.Carotid artery stenting versus carotid endarterectomy for treatment of asymptomatic carotid artery stenosis: a meta-analysis study[J]. Int Heart J, 2018, 38(3): 331-336.
[5] Kazemi K, Nikeghbalian Z, Yaghmaei S, et al.University of Wisconsin versus Normal Saline Solutions for Preservation of Blood Vessels of Brain Death Donors; A Histopathological Study[J]. Clin Transplant, 2018, 33(23): 5379-5382.
[6] 曲乐丰,主编. 颈动脉狭窄与脑卒中[M]. 上海:第二军医大学出版社, 2013.
[7] Chen YL, Sheu JJ, Sun CK, et al.MicroRNA-214 modulates the senescence of vascular smooth muscle cells in carotid artery stenosis[J]. Mol Med, 2020, 22(4): 99-100.
[8] Lung YJ, Weng WC, Wu CL, et al.Association Between Total Cholesterol and 5 year Mortality in Patients with Carotid Artery Stenosis and Poststroke Functional Dependence[J]. J Stroke Cerebrovasc, 2019, 35(5):221-225.
[9] Deʂer SB, Yucel SM, Demirag MK, et al.The association between platelet/lymphocyte ratio, neutrophil/lymphocyte ratio, and carotid artery stenosis and stroke following carotid endarterectomy[J]. Vascular, 2019, 27(6): 604-611.
[10] Yuan G, Zhou S, Wu W, et al.Carotid Artery Stenting Versus Carotid Endarterectomy for Treatment of Asymptomatic Carotid Artery Stenosis: A Meta-Analysis Study[J]. Int Heart J, 2018, 34(12): 3608-3611.
[11] J Jusufovic M, Skagen K, Krohg-Sørensen K, Skjelland M. Current Medical and Surgical Stroke Prevention Therapies for Patients with Carotid Artery Stenosis[J]. Curr Neurovasc Res, 2019, 16(1): 96-103.
[12] Sato K, Chitose SI, Sato K, et al.Permeability and Weibel-Palade Bodies of the Blood Vessels in the Human Vocal Fold Mucosa: Permeability of Blood Vessels of Vocal Fold[J]. The Laryngoscope, 2018, 128(008):1134-1136.
[13] 蔡楠, 何飞, 王芳, 等. 急性脑梗死患者血清神经元特异性烯醇化酶水平与梗死部位、体积及神经功能缺损的相关性[J]. 山东医药, 2018, 20(1): 73-75.
[14] 黄维, 霍秋玉, 阳世宇. 缺血性脑卒中患者血清S100β及NSE水平与神经缺损程度、认知障碍的相关性分析[J]. 浙江医学, 2019, 41(18): 2864-2866.
[15] 杨梅, 居克举, 仲玲玲,等. 急性症状性颈动脉狭窄患者斑块特征与微栓子信号的相关性研究[J]. 中风与神经疾病, 2018, 35(6): 538-540.
[16] Islam MT.Oxidative stress and mitochondrial dysfunction-linked neurodegenerative disorders[J]. Neurol Res, 2017, 39(1): 73-82.
[17] Mortimer R, Nachiappan S, Howlett DC.Carotid artery stenosis screening: where are we now?[J]. Br J Radiol, 2018, 91(1090): 20170380.
[18] 陈谦, 张合亮, 郭再玉. 症状性动脉粥样硬化性大脑中动脉重度狭窄支架术对认知功能的影响[J]. 广东医学, 2019, 40(2): 256-259.
[19] 闫丽敏, 代鸣明, 于航. 颈内动脉支架置入术联合药物治疗对重度颈内动脉狭窄者脑血流灌注及认知功能的影响[J]. 中山大学学报医学科学版, 2018, 39(1): 107-112.
[20] 卢浩浩, 郑传胜, 梁惠民, 等. 59例颈动脉支架置入术的临床分析[J]. 临床放射学杂志, 2016, 35(3): 458-461.