数字减影血管造影术对受检者颅内动脉血流速度及血浆内皮素-1的影响

Effect of cerebral angiography examination on mean velocity in intracerebral arteries and concentration of endothelin-1 in plasma

目的观察数字减影血管造影术(DSA)检查对受检者颅内动脉血流速度及血浆内皮素-1(ET-1)的影响,探讨DSA与脑血管痉挛之间的相关性。方法 63例受检者接受DSA检查,术前和术后分别进行血压测定和TCD检查,取左侧大脑中动脉和基底动脉为观察动脉,记录收缩期峰值血流速度及平均动脉压;术前和术后分别留取静脉血进行血浆ET-1测定;术前和术后进行比较。所有比较采用配对t检验。结果所有受检者中只有2例椎动脉迂曲的受检者术中发生一过性椎-基底动脉痉挛,其他受检者未出现脑血管痉挛。术后所观察动脉的血流速度峰值、血浆ET-1水平均高于术前(p<0.05),平均动脉压差异无统计学意义(p>0.05)。结论 DSA对受检者脑动脉血管内皮有一定刺激,但除了少数动脉迂曲的受检者外,大多数受检者进行DSA检查不会发生脑血管痉挛。

Objective To observe the effect of cerebral angiography examination on mean velocity in intracerebral arteries and concentration of endothelin-1 （ET-1 ） in plasma, and research the relativity between cerebral angiography examination and cerebral vasospasm （CVS）. Methods 63 subjects accepted cerebral angiography examination.Preoperative and postoperative ,mean arterial pressure ,peak systolic velocity in left middle cerebral artery and basilar artery detected by TCD and concentration of ET-1 in plasma were record and compared.Paired t-test were used to analyse. Results Of all subjects, only 2 subjects with vertebral artery tortuosity happened transient vertebrobasilar artery system spasm. Postoperative and preoperative compared, peak systolic velocity in left middle cerebral artery and basilar artery and concentration of ET-1 in plasma increased significantly, but no significant change in mean arterial pressure.Conclusion Cerebral angiography examination can stimulate endothelial cell of subjects, but most subjects can＇ t happen CVS except rare subjects with aterial tortuosity.