Double kissing crush technique for treatment of true coronary bifurcation lesions: two-year clinical outcomes from DKCRUSH-1 study

Standards for treating bifurcation lesions are crucial due to poor outcomes by percutaneous implantation of either bare metal stents or drug-eluting stents, even with several modified double-stent techniques including ＂T＂, ＂V＂, ＂Y＂, ＂culotte＂ and ＂simultaneous kissing stents （SKS）＂. Understanding the drawbacks in classical crush techniques, we proposed a novel double kissing （DK） crush technique being testified in our previous serial studies]＇2 The results from these randomized and pilot studies are describing a fantastic story---DK crush technique, by final kissing balloon inflation （FKBI） in 100% of lesions and high quality of kissing as assessed by both angiography and intravascular ultrasound, significantly improved the clinical outcome at a relative short-term follow-up. However, whether the advantage of the DK crush technique was sustained or not at a long-term remains unclear. The present study aimed to extend clinical follow-up and verify the differences between DK and classic crush techniques.     

Hemodynamic changes of fractional flow reserve after double kissing crush and provisional stenting technique for true bifurcation lesions

Background  Fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) is associated with fewer unfavorable events. However, the hemodynamic change in FFR after different stenting approaches for bifurcation lesions is still not fully studied. The aim of this study was to analyze the hemodynamic changes in FFR after double kissing (DK) crush and provisional side branch (SB) stenting (PS) for true coronary bifurcation lesions.

Methods  Seventy-five patients with true bifurcated lesions were randomly divided into DK (n=38) and PS (n=37) groups. Additional SB stenting in the PS group was required if there was any pinched SB ostium >70% stenosis, or ≥ type B dissection, or TIMI flow <grade 3. FFR at hyperemia in the main vessel (MV) and SB was measured prior- and post-stenting, and at 8 months follow-up.

Results  Baseline clinical, angiographic and lesion characteristics were matched well between the two groups, with the exception of the final kissing balloon inflation (FKBI, 100.0% in the DK vs. 83.8% in the PS group, P <0.001). Baseline FFR was comparable between the DK and the PS groups, however, the acute gain and late loss of SB FFR at 8-month follow-up in the DK group were 0.18±0.15 and –0.06±0.11, compared to 0.12±0.18 (P=0.044) and –0.002±0.07 (P=0.037) in the PS group, respectively. MV FFR post-stenting >0.94 was seen in about 40% of patients. There was no significant difference in the clinical events at 1-year follow-up between the two groups.

Conclusions  DK crush was associated with improved acute gain and late loss of SB FFR. The lower rate of FFR >0.94 after stenting underscored the further improvement of stenting quality.     

Effect of coronary bifurcation angle on clinical outcomes in Chinese patients treated with crush stenting: a subgroup analysis from DKCRUSH-1 bifurcation study

Background Bifurcation angles may have an impact on the clinical outcomes of crush stenting. We sought to compare high （≥60°） with low （〈60°） bifurcation angle in patients who underwent either classical or double kissing （DK） crush stenting for bifurcation lesions from the DKCRUSH-1 data base.
Methods There were 212 patients with 220 lesions, some with low-angle （n=138） and some with high-angle （n=74）. Angiography was indexed at 8-month after procedure. Primary endpoint was the occurrence of major adverse cardiac events （MACEs）, defined as cardiac death, myocardial infarction and target lesion revascularization （TLR）. Secondary endpoint included late lumen loss, the rate of restenosis, and final kissing balloon inflation （FKBI）.
Results At 8 months, clinical follow-up was 100%; angiographic follow-up was 75% in the low-angle group and 83.3% in the high-angle group. There were no significant differences in the FKBI between the high-angle group （91.43%） and the low-angle group （82.39%）. In the high angle group, there was a significant difference in contrast volume used （P=0.005） but no significant difference in acute gain, minimum lumen diameter （MLD）, late loss and diameter stenosis in the pre-bifurcation segment, post-bifurcation segment or side branch. When lesions were assigned into with- （n=-133） and without-FKBI （n=42）, significant side-branch late loss was seen in the group without-FKBI （（0.65±0.49） mm vs （0.47±0.62） mm, P=0.02）, with a resultant greater restenosis rate （37.68% vs 18.32%, P=0.001）. No difference was detected in the MACE free survival rate between the high and low angle groups （82.39% vs 82.36%, P=0.84）. The rate of stent thrombosis tended to be higher in the lower-angle group although there was no significant difference （P=0.38）. The TLR free survival rate was 87.2% in the with-FKBI group vs 73.5% in the without-FKBI group （P=0.001）. Cox regression analysis showed that the independent predictors for target vessel revascularization were the side branch stent MLD post stenting （hazard ratios （HR） 1.028, 95% CI 2.357-16.233, P=0.002）, lack of FKBI （HR 4.910, 95% CI 4.706-8.459, P=0.001） and unsatisfactory kissing （HR 3.120, 95% CI2.975-5.431, P=0.001）.
Conclusions Bifurcation angles do not influence the clinical outcome of crush stenting. Successful final kissing balloon inflation, regardless of bifurcation angles, can predict TLR.     

DK crush technique: modified treatment of bifurcation lesions in coronary artery

Bifurcation lesions are still technically challenging even in the era of modern stents.1 High incidence of restenosis both in main vessel and side branch limits the long-term prognosis although several kinds of techniques have been identified to be successful for coronary bifurcations.2-5 Reports have demonstrated the main reason for higher incidence of ostial side branch even though drug-eluting stent used in side vessel lies in that there were gaps in metal coverage and drug application.6-9 Therefore, new technique ensuring complete vessel scaffolding without gaps in drug delivery at the bifurcation is crush technique which is similar to other techniques including T- and Y- stenting still needing postdilatation of kissing balloon angioplasty to expand the stent fully in the ostial side branch and to prevent stent distortion in main vessel.10 As a result, kissing balloon angioplasty is a key step to improve the final result and to reduce the restenosis after stenting bifurcation lesions. However, kissing angioplasty is difficult to be underwent or impossible because operators usually fail to rewire two layers of metal strut, which would result in suboptimal stent deployment, a main reason of high incidence of restenosis, and acute- or-late-thrombosus. The present study reports modified DK crush technique improving success rate of kissing balloon angioplasty under the guidance of intravascular ultrasound (IVUS).     

DK crush technique: modified treatment of bifurcation lesions in coronary artery

Biefvuernca itnio nthe le esrioan osf maroede srtnil lst etnectsh·n1i calHlyig hch ianlcliednegninceg of restenosis both in main vessel and side branch limits the long-term prognosis although several kinds of techniques have been identified to be successful for coronary bifurcations·2-5 Reports have demonstrated the main reason for higher incidence of ostial side branch even though drug-eluting stent used in side vessel lies in that there were gaps in metal coverage and drug application·6-9…     

Hemodynamic change in wall shear stress in patients with coronary bifurcation lesions treated by double kissing crush or single-stent technique

Background  Fluid dynamic mechanisms attributed to coronary bifurcation lesions remain a subject of study. The present study aimed at investigating the hemodynamic change of wall shear stress (WSS) in patients with coronary bifurcation lesions treated by double kissing (DK) crush or one-stent with final kissing balloon inflation (FKBI).

Methods  Eighty-one patients with bifurcation lesions treated by stenting who had 3-D model reconstruction were studied. The bifurcation vessels were divided into main vessel (MV), main branch (MB), side branch (SB), and polygon of confluence (POC). MB and SB were classified by internal- and lateral-subsegments, respectively.

Results  The baseline magnitude of WSS in proximal MV, POC-MV, POC-MB, POC-SB and MB-internal segments increased significantly, compared to MB-lateral, SB-internal and SB-lateral. DK crush had the potential of uniformly reducing WSS, turbulent index and the WSS gradient. The WSS value at the POC-SB and SB in the one-stent group remained higher. The turbulent index and WSS gradient between the POC-SB minus the SB-lateral had equal predictive values for in-stent restenosis (ISR).

Conclusion  Fluid dynamic results favor the use of DK crush over the one-stent technique.

     

Coronary bifurcation lesions treated with double kissing crush technique compared to classical crush technique: serial intravascular ultrasound analysis

Background The double kissing (DK) crush technique is a modified version of the crush technique.It is specifically designed to increase the success rate of the final kissing balloon post-dilatation,but...     

血管内超声动态观察左主干分叉病变行单支架术中最终对吻技术对分叉解剖结构的影响

目的：探讨在单支架横跨支架术式治疗左主干分叉病变中,使用血管内超声（IVUS）动态观察最终对吻技术对分叉区域解剖结构的影响。方法：前瞻性入组36例左主干分叉病变且行单支架横跨术式,所有患者在术前分别从前降支（run1）、回旋支（run2）回拉IVUS,支架释放后从前降支回拉IVUS（run3）,最终对吻后分别从前降支（run4）、回旋支（run5）回拉IVUS;分析患者的临床特征、造影资料和IVUS数据。结果：患者年龄（63.8±12.1）岁,左主干真性分叉病变占22.2%。相较于术前IVUS（run2）,最终对吻术后的IVUS（run5）发现回旋支开口处管腔面积[（7.30±3.08）mm2 vs（. 6.37±2.66）mm2,P＜0.05]和血管面积[（13.10±3.27）mm2 vs.（12.47±2.93）mm2,P =0.012）]均明显减小,而斑块面积差异无统计学意义[（5.80±2.02）mm2 vs.（ 6.10±2.09）mm2,P =0.128];回旋支开口处管腔面积变化与血管面积变化相关（r =0.787,P ＜0.001）,而与斑块面积变化不相关（r =0.187,P =0.276）。相较于支架释放后IVUS（run3）,最终对吻术后的IVUS（run4）发现多边形区域面积[（9.80±2.09）mm2 vs.（ 11.48±2.65）mm2,P＜0.05]、左主干远端面积[（9.91±1.73）mm2 vs.（11.85±2.38）mm2,P＜0.05]和左主干最小支架内面积[（9.61±1.53）mm2 vs（. 11.34±2.33）mm2,P＜0.05]均明显增加,支架贴壁不良现象减少（83.3% vs. 61.1%,P =0.035）,但是伴随支架不对称指数增加,多边形区域[（1.23±0.14 vs. 1.33±0.12,P ＜0.05）;左主干远端（1.18±0.09 vs. 1.25±0.10,P ＜0.05）;左主干最小管腔面积处（1.17±0.09 vs. 1.24±0.10,P ＜0.05）。结论：在左主干分叉病变行单支架横跨支架术中,最终对吻后回旋支开口面积明显减小,与嵴移位相关;最终对吻增加左主干及多边形区域支架内面积,减少支架贴壁不良现象,但是会增加支架不对称指数。     

球囊支架对吻术治疗冠状动脉分叉病变的疗效观察

目的 观察球囊支架对吻术治疗冠状动脉分叉病变的临床疗效。方法 连续入选2015年5月至2016年4月45例于同济大学附属东方医院心内科行球囊支架对吻术的冠状动脉分叉病变的患者,观察患者的临床特点、术中病变特点及术后影像学及短期临床事件情况的发生。结果 45例患者共有48处分叉病变处成功进行了球囊支架对吻治疗。其中大多数病变为(70.8%)为Medina1,1,1型。术后即刻TIMI3级血流,主支为100%,分支为96%。2例患者边支置入支架。术中边支内被拘禁的导丝及球囊均能顺利撤出。住院期间及出院1月内无明显的主要心脏不良事件发生。结论 在单支架方法(必要时分支置入支架)治疗分叉病变时,球囊支架对吻术是一种可行、有效的技术,能有效降低边支闭塞的风险,降低住院期间的主要心脏不良事件的发生率。     

切割球囊在处理冠心病分叉病变分支血管中的疗效和安全性分析

目的评价经皮冠状动脉腔内切割球囊成形术（PTCBA）治疗冠脉分叉处分支血管中病变的安全性及疗效。方法46例冠心病患者52个分叉病变主支病变,应用经皮冠状动脉腔内切割球囊成形术（PTCA）预扩张后置入支架,分支病变单行PTCBA而不置入支架,观察其手术过程、手术成功率、并发症和近期随访结果。结果46例患者52个分叉病变中位于前降支/第一对角支占65%,回旋支/钝圆支占27%,右冠脉/后降支或后侧支占8%。对分支血管行PTC-BA后有5例因内膜严重撕裂而置入支架,1例术中出现心包填塞,行心包穿刺引流症状缓解后行心外科急诊手术15 d出院,其余病变残余狭窄为20%-50%。PTCBA成功率达88.5%,无院内死亡、急性心肌梗死（AMI）等严重并发症。对手术成功的40例患者术后临床随访6个月,无死亡及AMI等心脏事件发生。结论PTCBA治疗冠脉分叉处分支血管病变安全、有效,其成功率高,并发症少,近期疗效满意。     

经皮冠状动脉支架术后再狭窄患者血管内皮功能的变化及其临床意义

目的研究经皮冠状动脉(冠脉)支架术后再狭窄患者血管内皮功能的变化及其临床意义。方法67例接受经皮冠脉支架术的冠心病患者术前术后及18例正常对照组测定肱动脉流量介导的舒张(FMD)和非内皮依赖性舒张功能(NMD)。结果再狭窄与无再狭窄组支架术前的FMD分别为(22.4±4.2)%和(22.6±6.4)%,与正常对照组(25.9±5.2)%比较显著减低(P<0.05)。支架术后6个月再狭窄16例,占23.9%。再狭窄组与无再狭窄组的FMD比较,术前差异无显著性(P>0.05),但术后再狭窄组的FM(D18.4+3.9)%较术前明显降低(P<0.01),而无再狭窄的术前术后(22.6±6.4)%与(21.9±6.9)%差异无显著性。结论支架术后再狭窄组的内皮依赖性舒张功能显著减低,应采取措施保护和修复血管内皮功能。无创性超声检测肱动脉FMD对预测冠脉内支架术后再狭窄具有一定的临床意义。     

食管支架置入术治疗中晚期食管贲门癌35例分析

目的 探讨食管支架置入术对晚期食管贲门癌的治疗方法、疗效和并发症的处理.方法 对35例中晚期食管贲门癌患者采用食管金属支架置入术.结果 食管狭窄的主要症状吞咽困难得以改善,近期疗效达100%.35例患者均一次性置入支架成功,虽有不同程度的并发症发生,但处理后均得到缓解或消失.结论 金属支架置入术是治疗中晚期食管贲门癌食...     

膝关节骨性关节炎患者肌骨超声滑膜病变表现与Lysholm评分的相关性及其临床应用分析

目的探讨膝关节骨性关节炎患者肌骨超声滑膜病变表现与Lysholm评分的相关性及其临床应用分析。方法本次研究采取横断面观察研究,选取2016年5月～2017年5月我院收治的膝关节骨性关节炎患者68例,应用多重线性回归建立回归方程,对Lysholm评分与肌骨超声滑膜病变表现之间的相关性分析。结果经临床检查结果显示,女性膝关节骨性关节炎的发病率明显高于男性,其中最常见的临床症状为关节积液(66.2%),其次是滑膜增生47.1%,其中相对最为少见的是腘窝囊肿(17.6%),在Lysholm评分中支撑、交锁以及疼痛与肌骨超声滑膜病变有相关性(P0.05),Lysholm评分中的支撑与肌骨超声关节积液之间呈正相关,Lysholm评分中的交锁与肌骨超声关节积液之间呈负相关。结论对于膝关节骨性关节炎患者采用肌骨超声检查可以使关节滑膜病变情况很好的显示,主要的临床表现为关节积液和滑膜增生,Lysholm评分与肌骨超声滑膜病表现之间关系密切。     

药物涂层球囊治疗对冠状动脉再狭窄老年患者靶血管内膜反应、靶病变血运重建的影响

目的 探讨药物涂层球囊治疗冠状动脉再狭窄老年患者对靶血管内膜反应、靶病变血运重建的影响及安全性。方法 选取2017年11月—2019年1月锦州医科大学附属第一医院收治的冠状动脉再狭窄老年患者198例，根据随机数字表法分为研究组与对照组，每组99例。对照组采取切割球囊治疗，研究组采取药物涂层球囊治疗。对两组治疗前和治疗3个月、6个月后靶血管内膜反应、心功能、中国心血管病人生活质量评定问卷（CCQQ）评分、不良心血管事件发生率、管腔再狭窄率及靶病变血运重建发生率进行比较。结果 两组最小腔径、最小管腔面积比较，差异有统计学意义（P <0.05），两组左室射血分数、NT-proBNP及每搏输出量比较，差异有统计学意义（P <0.05），两组不良心血管事件总发生率比较，差异无统计学意义（P >0.05），对照组靶病变血运重建发生率高于研究组（P <0.05）。两组CCQQ评分比较，差异有统计学意义（P <0.05）。结论 药物涂层球囊治疗冠状动脉再狭窄老年患者可明显改善靶血管内膜反应，降低靶病变血运重建发生率，促进心功能恢复，可以改善生活质量。     

功能磁共振对颈动脉狭窄患者支架植入术前后脑功能改变的评估作用

目的研究磁共振灌注成像(PWI)及磁共振扩散张量成像(DTI)对颈动脉狭窄患者支架植入术前后脑功能变化的评估作用。方法选取20例经脑血管造影证实的单侧颈动脉重度狭窄患者,于颈动脉支架植入术(CAS)前后行PWI、DTI检查,评估术前术后脑血流量(CBF)、脑血流容积(CBV)、平均通过时间(MTT)的变化以及各向异性分数(FA)的变化情况。结果 20例患者术前双侧脑灌注存在差异,患侧MTT延长,CBF、CBV降低,术后患侧MTT缩短(t=4.396,P=0.000),CBF升高(t=-2.812,P=0.011),差异有统计学意义;CBV变化不明显。术前患侧额叶FA值较对侧降低(t=-2.539,P=0.013),术后患侧额叶FA值较术前升高(t=-2.322,P=0.032),而顶叶、枕叶、颞叶、内囊前肢、内囊后肢FA值变化不明显。结论联合应用PWI、DTI技术可提示脑组织血流灌注及脑白质受损情况,从而评估单侧颈动脉狭窄患者CAS术前术后脑功能的变化。     

血清胆碱酯酶在慢性阻塞性肺疾病伴呼吸衰竭行无创呼吸机辅助呼吸患者中的变化及意义

目的：探讨血清胆碱酯酶(ChE)在慢性阻塞性肺疾病(COPD)伴呼吸衰竭需经无创呼吸机辅助呼吸治疗患者中的变化特点,并分析其临床意义。方法选取我院呼吸内科2014年2月至2015年1月收治的104例COPD伴呼吸衰竭患者,按是否需要行无创呼吸机辅助呼吸治疗分为观察组45例和对照组59例。对照组行常规药物治疗,观察组在对照组的基础上采用无创呼吸机辅助治疗。比较两组患者的治疗效果及入、出院时全血胆碱酯酶活力（blChE）、红细胞胆碱酯酶活力（eChE）、血浆胆碱酯酶活力(pChE)的变化。结果观察组患者治疗的总有效率为100.00%,与对照组的98.31%比较差异无统计学意义(P>0.05);观察组患者入院时的blChE、eChE、pChE分别为(3.82±1.26)×1012/L、(3.08±0.76)×1012/L、（0.56±0.21）×1012/L,明显低于对照组的(5.08±1.35)×1012/L、(3.72±0.83）×1012/L、(0.83±0.26)×1012/L,差异均有统计学意义(P<0.05);观察组出院时的blChE、eChE、pChE分别为（4.96±1.33）×1012/L、(3.69±0.84)×1012/L、（0.71±0.25）×1012/L,与对照组的(5.12±1.27)×1012/L、(3.81±0.72)×1012/L、（0.75±0.29）×1012/L比较差异均无统计学意义(P>0.05);与治疗前相比较,观察组治疗后blChE、eChE、pChE水平均明显更高(P<0.05),而对照组则差异无统计学意义(P>0.05)。结论 COPD伴呼吸衰竭患者ChE水平有明显降低,经无创呼吸机治疗后呈现明显的升高趋势,故ChE可作为判断无创呼吸机辅助呼吸治疗COPD伴呼吸衰竭患者临床疗效的评价指标。     

系统性红斑狼疮合并血小板减少治疗前后血中细胞因子的变化及意义

目的:探讨系统性红斑狼疮(SLE)伴血小板减少患者血中几种细胞因子的变化.方法:采用ELISA法对58例SLE血中IL-3,IL-4,IL-6,IL-8,TNF-α水平及治疗后血小板恢复正常44例血中上述细胞因子的变化进行检测.结果:患者IL-3水平下降,其余细胞因子均增加,与血小板减少程度具有相关性.随着治疗好转,相应细胞因子改变逐渐恢复,但IL-18、TNF-α未完全恢复正常.结论:几种细胞因子均参与了SLE发病中血小板的损伤过程.IL-8、TNF-α的不全恢复,表明SLE体内异常免疫状态尚未完全控制,对监测SLE的病情及治疗具有重要意义.     

补虚劳经典药膳粥改善脾肾阳虚证慢性疲劳 综合征患者临床症状研究

目的 探讨补虚劳经典药膳粥对脾肾阳虚证慢性疲劳综合征（CFS）患者临床症状的改善效果。 方法 在成都市某三甲中医院门诊选取符合纳入标准的CFS（脾肾阳虚证）患者86 例,采用随机数字表法分 成试验组和对照组,各43 例。对照组采用发放健康教育手册、面对面交谈的个体指导与讲座、微信群的集体 指导相结合的形式实施为期8 周的健康教育,每2 周1 次,共4 次;试验组在此基础上食用改良后的补虚劳 经典药膳粥,隔天1 次,每次400 ～ 500 ml,4 周为1 个疗程,共2 个疗程。两组患者均于干预前、干预4 周末、 干预8 周末采用疲劳量表-14（FS-14）、躯体和心理健康报告（SPHERE）分别评价患者疲劳症状和伴随症 状,采用脾肾阳虚中医证候积分评价患者中医证候的改善情况。结果 试验组干预后各时间点FS-14 总分和 SPHERE 评分均低于同期对照组（P <0.05）;FS-14 总分和SPHERE 评分组间效应、时间效应及两者交互效 应差异均有统计学意义（P <0.05）。试验组干预后各时间点中FS-14 总分和SPHERE 评分两两比较,后一时 间点得分均低于前一时间点（P <0.05）。中医证候：干预4 周后,试验组脾肾阳虚证候总分、倦怠乏力、食 少纳呆、脘腹胀满条目低于对照组（P <0.05）,干预8 周后,除腰部冷痛条目外,其余条目及总分试验组均低 于对照组（P <0.05）;中医证候总分组间效应、时间效应及两者交互效应差异有统计学意义（P <0.05）。试验 组干预后各时间点中医证候总分两两比较,后一时间点得分均低于前一时间点,差异有统计学意义（P <0.05）。 结论 补虚劳经典药膳粥可改善CFS 患者的疲劳,减少伴随症状,并能有效改善患者的中医证候。     

Graves眼病患者经~(131)I治疗后血清IL-17、IGF-1、ICAM-1检测分析及临床意义

目的:通过血清中白介素-17(IL-17)、胰岛素样生长因子-1(IGF-1)和可溶性细胞间粘附分子-1(ICAM-1)的水平表达及其相关性,对经~(131)I治疗的甲亢伴有甲状腺相关眼病患者的眼眶活动性进行评价。方法:88例Graves眼病(GO)患者依据临床活动性评分(CAS)标准分为GO活动期组(活动期组)52例、GO静止期组(静止期组)36例,另设Graves病无眼病组(无眼病组)34例和健康对照组(对照组)26例。采用酶联免疫吸附法测定血清IL-17、IGF-1、ICAM-1水平,同时测定血清游离三碘甲状原氨酸(FT_3)、游离甲状腺素(FT_4)、超敏促甲状腺素(sTSH)、促甲状腺素受体抗体(TRAb)水平。结果:经~(131)I治疗后,GO活动期组患者血清IL-17、IGF-1、ICAM-1水平明显高于健康对照组、静止期组和无眼病组(P<0.01);静止期组的血清IL-17水平高于健康对照组和无眼病组(P<0.05)。无眼病组的血清IL-17、IGF-1和ICAM-1水平与健康对照组比较,均无统计学差异(P> 0.05)。患者血清IL-17与ICAM-1、IGF-1的相关性分别为r=0.847、r=0.806(P<0.01);IGF-1与ICAM-1的相关性分别为r=0.882(P<0.01)。结论:Graves眼病患者经~(131)I治疗后血清IL-17、IGF-1、ICAM-1的表达水平明显高于静止期组。无眼病组及健康对照组,三个指标具有良好的相关性,对于GO眼病的病变进展监测和治疗效果观察具有一定的指导意义。     

血清sICAM-1、VEGF在缺血性脑卒中致血管性痴呆患者中的表达及临床意义

目的 观察血清可溶性细胞间黏附分子-1(sICAM-1）、血管内皮生长因子（VEGF）在缺血性脑卒中致血管性痴呆（VD）患者中的表达及临床意义。方法 回顾性分析2020年1月—2021年6月南京中医药大学连云港附属医院收治的112例缺血性脑卒中患者的临床资料,发生VD的31例缺血性脑卒中患者为VD组,其余81例为非VD组。另选取该院同期体检的健康人员55例为健康组。比较3组血清sICAM-1、VEGF水平;比较VD组和非VD组的临床资料,采用多因素逐步Logistic回归分析缺血性脑卒中后发生VD的影响因素;绘制受试者工作特征（ROC）曲线分析血清sICAM-1、VEGF单独及联合检测对缺血性脑卒中后发生VD的预测价值。结果 与健康组比较,非VD组、VD组血清sICAM-1、VEGF水平升高（P <0.05）;与非VD组比较,VD组血清sICAM-1水平升高（P <0.05）,血清VEGF水平降低（P <0.05）。与非VD组比较,VD组吸烟占比、高血压及NIHSS评分升高（P <0.05）,两组的年龄、性别构成、BMI、饮酒、VD家族史、高盐饮食、高脂血症、糖...