远端血管通路导管治疗急性脑梗死对血清金属基质蛋白酶-9、血管内皮生长因子的影响

The effect of distal vascular access catheter in the treatment of acute cerebral infarction on serum metalloproteinase-9 and vascular endothelial growth factor

目的:研究急性脑梗死(ACI)患者行远端血管通路导管治疗的效果。方法:选择70例ACI患者,按照随机数字表法分为导管组和支架组,每组35例。其中支架组采用支架取栓治疗,导管组采用远端血管通路导管抽吸取栓治疗,利用酶联免疫吸附法(ELISA)检测血清金属基质蛋白酶-9(MMP-9)、血管内皮生长因子(VEGF)水平,采用美国国立卫生研究院脑卒中量表(NIHSS)和日常生活能力量表(ADL)量表评价患者神经功能和日常生活能力恢复情况,比较两组不良反应发生率。结果:治疗前两组的MMP-9、VEGF水平差异无统计学意义(P>0.05),治疗后两组的MMP-9、VEGF水平均降低,并且导管组变化幅度大于支架组变化幅度,差异有统计学意义(P<0.05);治疗前两组的NIHSS、ADL评分差异无统计学意义(P>0.05),治疗后两组的NIHSS评分均降低,ADL评分均升高,并且导管组变化幅度大于支架组变化幅度,差异有统计学意义(P<0.05);两组主要不良事件包括动脉夹层、心肌梗死、消化出血,其中导管组不良事件发生率为7.5%,支架组不良事件发生率为25.00%,导管组不良事件占比更低,差异有统计学意义(P<0.05)。结论:远端血管通路导管治疗ACI患者可降低血清因子,改善患者神经功能和日常生活能力,避免发生不良事件。

Objective To study the effect of distal vascular access catheter treatment in patients with acute cerebral infarction(ACI).Method 70 ACI patients were selected and divided into catheter group and stent group according to the random number table method,each group of 35 cases,of which the stent group was treated with stent embolization and the catheter group was treated with distal vascular pathway catheterization and thrombus extraction.The enzyme-linked immunosorbent assay was used to detect the serum metalloproteinase-9(MMP-9)and vascular endothelial growth factor(VEGF)levels.The NIHSS and ADL scales were used to evaluate the patient's nerves and the recovery of functions and activities of daily living,the incidence of adverse reactions between the two groups of patients were compared.Results Before treatment,there was no significant difference in the levels of MMP-9 and VEGF between the two groups of patients(P>0.05).After treatment,the levels of MMP-9 and VEGF in the two groups decreased,and the change in the catheter group was greater than that in the stent group(P<0.05);the NIHSS and ADL scores of the two groups of patients before treatment were not statistically significant(P>0.05).After treatment,the NIHSS scores of the two groups of patients decreased,and the ADL scores increased.In addition,the magnitude of change in the catheter group was greater than that in the stent group(P<0.05);the main adverse events of the two groups of patients included arterial dissection,myocardial infarction,and digestive hemorrhage.The incidence of adverse events in the catheter group was 7.5%,the incidence of adverse events in the stent group was 25.00%,and the incidence of adverse events in the catheter group was lower(P<0.05).Conclusion The treatment of ACI patients with distal vascular access catheter can reduce serum factors,improve patients'neurological function and ability of daily living,and avoid adverse events.It is worthy of praise.