电项针对颈动脉狭窄致中风先兆患者AngⅡ、TXB2水平及血管内皮功能的影响

Effect of Nape Electroacupuncture on AngⅡ and TXB2 Levels and Vascular Endothelial Function in Patients with Stroke Aura Caused by Carotid Stenosis

目的观察电项针对颈动脉狭窄致中风先兆患者血栓素B2(TXB2)、血管紧张素Ⅱ(AngⅡ)水平及血管内皮功能的影响。方法将88例中风先兆患者以随机数字表法分组,44例患者为研究组,44例患者为对照组。对照组采用基础治疗同时予抗血小板聚集治疗,研究组在对照组基础上予电项针治疗。治疗前、后检测两组患者血清神经元特异性烯醇化酶(NSE)、一氧化氮合酶(iN OS)、脑源性神经营养因子(BDNF)、血栓素B2(TXB2)、血管紧张素Ⅱ(AngⅡ)、一氧化氮(NO)、内皮素(ET)-1、可溶性血管细胞黏附分子(sV CAM)-1、血小板黏附性(PAdT)和血小板聚集率(PAgT)水平,采用经颅多普勒超声检测仪测定患者头颈部动脉平均血流速度(Vm)、最大峰值流速(Vs)、血管阻力指数(RI)水平,采用数字减影血管造影术检测两组患者血管狭窄程度。结果研究组血清NSE、iNOS、TXB2、AngⅡ、PAgT、PAdT、sVCAM-1及ET-1水平低于对照组(P<0.05),研究组血清BDNF、NO和Vm、Vs水平高于对照组(P<0.05);研究组患者RI、血管狭窄程度低于对照组(P<0.05)。结论在常规治疗基础上,电项针治疗颈动脉狭窄致中风先兆患者可降低NSE、iNOS、TXB2和AngⅡ水平,提高BDNF水平,减少神经损伤,控制血小板聚集,提升血管内皮功能,改善患者血管狭窄程度和血流动力学。

Objective To observe the effect of nape electroacupuncture on thromboxane(TX)B2 and angiotensin(Ang)Ⅱlevels and vascular endothelial function in patients with stroke aura caused by carotid stenosis.Method Eighty-eight patients with stroke aura were allocated,using a random number table,to a study group(44 cases)and a control group(44 cases).The control group received antiplatelet aggregation treatment as well as basic treatment,and the study group received nape electroacupuncture additionally.Serum neuron specific enolase(NSE),nitric oxide synthase(iN OS),brain-derived neurotrophic factor(BDNF),thromboxane(TX)B2,angiotensin(Ang)Ⅱ,nitric oxide(NO),endothelin-1(ET-1),soluble vascular cell adhesion molecule-1(s VCAM-1),platelet adhesion(PAd T)and platelet aggregation rate(PAgT)were measured in the two groups of patients before and after treatment.Carotid mean flow velocity(Vm),systolic peak flow velocity(Vs)and vascular resistance index(RI)were measured by transcranial Doppler ultrasonography.The degree of vascular stenosis was detected by digital subtraction angiography.Result Serum NES,iN OS,TXB2,AngⅡ,PAgT,PAd T,sV CAM-1 and ET-1 levels were lower in the study group than those in the control group(P<0.05).Serum BDNF and NO levels,and Vm and Vs were higher in the study group than those in the control group(P<0.05).RI and the degree of vascular stenosis were lower in the study group of patients than those in the control group(P<0.05).Conclusion On the basis of conventional treatment,nape electroacupuncture can lower NES,i NOS,TXB2 and AngⅡlevels,increase BDNF levels,reduce nerve injury,control platelet aggregation,improve vascular endothelial function and hemodynamics and decrease the degree of vascular stenosis in treating patients with stroke aura caused by carotid stenosis.