神经介入溶栓术对缺血性脑血管病患者血管内皮功能及血流动力学的影响探讨

Effects of neurointerventional thrombolysis on vascular endothelial function and hemodynamics in patients with ischemic cerebrovascular disease

目的探讨神经介入溶栓术对缺血性脑血管病患者血管内皮功能及血流动力学的影响。方法98例缺血性脑血管病患者,按随机数字表法分为试验组和对照组,每组49例。对照组采用重组组织型纤溶酶原激活剂进行静脉溶栓治疗,试验组在对照组基础上联合神经介入溶栓术治疗。比较两组患者治疗后血管再通情况以及治疗前后内皮功能[臂踝脉搏波传播速度(ba-PWV)、踝肱指数(ABI)、内皮依赖性血管舒张功能(FMD)]、血流动力学[脉搏速度(WV)、血管特性阻抗(ZCV)、外周阻力(RV)]。结果治疗后,试验组患者血管再通率93.88%高于对照组的77.55%,差异具有统计学意义(P<0.05)。治疗后,两组患者ba-PWV、ABI水平均低于治疗前,FMD高于治疗前,且试验组患者ba-PWV(1201.16±203.18)cm/s、ABI(0.87±0.20)均低于对照组的(1352.89±230.45)cm/s、(1.03±0.21),FMD(5.87±1.23)%高于对照组的(5.12±1.19)%,差异均具有统计学意义(P<0.05)。治疗后,两组患者WV、ZCV、RV均低于治疗前,且试验组患者WV(18.16±4.51)m/s、ZCV(84.19±19.21)kPa·s/m、RV(52.31±12.23)kPa·s/m均低于对照组的(21.18±4.97)m/s、(93.35±21.46)kPa·s/m、(60.34±15.16)kPa·s/m,差异均具有统计学意义(P<0.05)。结论神经介入溶栓术治疗缺血性脑血管病可提升患者的治疗效果,改善血管内皮功能及血流动力学水平。

Objective To discuss the effects of neurointerventional thrombolysis on vascular endothelial function and hemodynamics in patients with ischemic cerebrovascular disease.Methods A total of 98 patients with ischemic cerebrovascular disease were divided into experimental group and control group according to the random numerical table,with 49 cases in each group.The control group was treated with recombinant tissue plasminogen activator for intravenous thrombolysis,while the experimental group was treated with neurointeRVentional thrombolysis on the basis of the control group.Both groups were compared in terms of vascular recanalization after treatment,endothelial function[brachial-ankle pulse wave velocity(ba-PWV),ankle-brachial index(ABI),flow-mediated dilation(FMD)],hemodynamics[pulse wave velocity(WV),vascular characteristic impedance(ZCV),peripheral resistance(RV)]before and after treatment.Results After treatment,the vascular recanalization rate in the experimental group was 93.88%,which was higher than 77.55%in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of ba-PWV and ABI in both groups were lower than those before treatment in this group,and the levels of FMD were higher than those before treatment in this group;the ba-PWV(1201.16±203.18)cm/s and ABI(0.87±0.20)in the experimental group were lower than(1352.89±230.45)cm/s and(1.03±0.21)in the control group;the FMD(5.87±1.23)%in the experimental group was higher than(5.12±1.19)%in the control group;the differences were all statistically significant(P<0.05).After treatment,the WV,ZCV and RV of the two groups were lower than those before treatment in this group;the WV(18.16±4.51)m/s,ZCV(84.19±19.21)kPa·s/m,and RV(52.31±12.23)kPa·s/m in the experimental group were all lower than(21.18±4.97)m/s,(93.35±21.46)kPa·s/m,and(60.34±15.16)kPa·s/m in the control group;the differences were all statistically significant(P<0.05).Conclusion Neurointerventional thrombolysis in the treatment of ischemic cerebrovascular disease can improve the therapeutic effect,vascular endothelial function and hemodynamics.