灌注相关的血清学指标在重度颈动脉狭窄支架植入后的变化及意义

Changes and significance of perfusion-related serological indicators after stent implantation for severe carotid stenosis

目的探讨重度颈动脉狭窄患者支架植入术前及术后血清中神经元特异烯醇化酶(NSE)、基质金属蛋白酶9(MMP9)、S100B蛋白(S100B)、血红素加氧酶1(HO-1)、一氧化碳(CO)的浓度变化对血流灌注改善的评估及预测作用。方法行支架植入术患者44例为手术组,留取患者术前(T1)、术后第一天(T2)、第三天(T3)血液;无狭窄患者30例为对照组;检测两组血清神经元特异烯醇化酶(NSE)、基质金属蛋白酶9(MMP9)、S100B蛋白(S100B)、血红素加氧酶1(HO-1)、一氧化碳(CO)的含量并作统计学分析。结果手术组术后血清中NSE、MMP9、S100B、CO的浓度较术前降低,HO-1浓度T3较T1升高(P<0.01)。结论重度颈动脉狭窄支架植入术后NSE、MMP9、S100B、CO降低可评估术后血流灌注改善对脑的保护;术后HO-1升高可做为血流灌注改善程度的评估指标。

Objective To investigate the changes in concentrations of neuron-specific isoenolase(NSE),matrix metalloproteinase 9(MMP9),S100B protein(S100B),heme oxygenase 1(HO-1)and carbon monoxide(CO)for assessment and prediction of improvement of blood perfusion in patients with severe carotid stenosis.Methods We selected 44 patients with stent implantation as operation group.Blood samples were collected before operation(T1),the first day after operation(T2)and the third day after operation(T3).Thirty patients without stenosis were used as control group.Serum levels of NSE,MMP9,S100,HO-1 and CO were detected in the two groups and statistical analysis was performed.Results After operation,the concentrations of serum NSE,MMP9,S100 and CO were decreased when compared to before operation while serum HO-1 concentration was increased when compared T1 with T3(P<0.01).Conclusion The decrease of NSE,MMP9,S100B and CO after stent implantation for severe carotid artery stenosis can be used to evaluate the protection of cerebral perfusion improvement and the increase of postoperative HO-1 can be used as an index for evaluation of degree of perfusion improvement.