颈动脉内膜剥脱术围手术期生化标志物预警作用的研究进展

Advances in the Biochemical Markers of Complications Associated with Carotid Endarterectomy

颈动脉内膜剥脱术(CEA)可解除颈动脉粥样硬化狭窄所致脑缺血,多项研究已证实其临床效果明确、可靠。但是,对于CEA围手术期的严重并发症——卒中和死亡,目前尚缺乏有效的早期诊断手段。尽管以往研究了多种生化标志物对卒中的预警作用,且其重要性已日益受到重视,但到目前为止还没有明确有效的标志物可用于临床。颈动脉狭窄及CEA围手术期并发症与卒中有共同的发生、发展机制,目前已研究有部分生化标志物在CEA围手术期的预警作用,如S100B蛋白、人基质金属蛋白酶9、非对称二甲基精氨酸和神经元特异烯醇化酶,但均处于探索阶段,本文总结了国内外的研究进展。

Carotid endarterectomy （CEA） has been proved to be an effective surgery to treat the cerebral ischemia caused by carotid atherosclerotic stenosis. However, there is still no effective mean for the early diagnosis of the CEA- related severe complications such as stroke and death. Many studies have explored the potential biomarkers for stroke alert, although there is still a long way to go for their actual application in clinical settings. The carotid atherosclerotic stenosis, the perioperative complications of CEA, and the stroke share similar pathogenic mechanisms, and some biomarkers such as S100B, matrix metalloproteinase 9, asymmetric dimethylarginine, and neuron-specific enolase have been studied in the clinical trails of CEA. This article summarizes recent advances in this field.