颈动脉支架置入术后内皮功能的变化及与再狭窄的相关研究

目的 探讨颈动脉支架置入术后假性血友病因子(vWF)、内皮素1(ET-1)的水平变化及与再狭窄的关系.方法 检测67例短暂性脑缺血发作患者行颈动脉支架置人术前,术后1 h、2周、1个月、6个月、1年血浆vWF、ET-1水平.患者术后1年常规进行头颈血管CTA检查,根据结果分为再狭窄组和无狭窄组,并对两组vWF、ET-1水平进行比较.结果 随访中1例死亡,4例失访.14例患者存在不同程度的再狭窄,其中3例再狭窄≥50%.与术前比较,术后1 h、6个月vWF 水平升高,术后1 h、2周、6个月ET-1水平升高,差异均有统计学意义(P<0.05).与无狭窄组比较,再狭窄组术后1 h、2周、6个月vWF水平升高,术后1 h、2周、1个月、6个月ET-1水平升高,差异均有统计学意义(P<0.05).结论 颈动脉支架置入术后短期(2周内)vWF、ET-1水平持续升高,术后6个月再次升高者发生再狭窄的危险性增加,监测vWF、ET-1水平对判断患者的远期预后有一定价值.

Abstract：

Objective To explore the changes of levels of von willebrand (vWF) and endothelin-1 (ET-1) and their relations with restenosis in patients performed carotid artery stenting (CAS).Methods The levels of vWF and ET-1 in 67 patients were measured before CAS and 1 h, 2 w, 1 and 6months, and 1 y after the stenting. All the patients were divided into restenosis group and non-restenosis group according to the examining results of cervical CTA 1 y after CAS. Results In the follow-up survey, 1 patient was died and 4 were out of touch. Fourteen patients had restenosis of different degrees;the restenosis rates of 3 patients was more than 50 percent. The level of vWF 1 h and 6 months after CAS and the level of ET-1 1 h, 2 w and 6 months after CAS were increased rapidly as compared with those before CAS (P<0.05). As compared with those in the on-restenosis group, the level of vWF 1 h, 2 w and 6 months after CAS and the level of ET-1 1 h, 2 w, 1 and 6 months after CAS in the restenosis group were obviously increased (P<0.05). Conclusion The levels of vWF and ET-1 increase continually in a short term (within 2 weeks) after CAS, and increase once again 6 months after CAS which increases the risk of restenosis.Monitoring the levels of vWF and ET-1 may be of great value in judging long-term prognosis.

Changes of endothelial function and its relation with restenosis in patients performed carotid artery stenting

Objective To explore the changes of levels of von willebrand (vWF) and endothelin-1 (ET-1) and their relations with restenosis in patients performed carotid artery stenting (CAS).Methods The levels of vWF and ET-1 in 67 patients were measured before CAS and 1 h, 2 w, 1 and 6months, and 1 y after the stenting. All the patients were divided into restenosis group and non-restenosis group according to the examining results of cervical CTA 1 y after CAS. Results In the follow-up survey, 1 patient was died and 4 were out of touch. Fourteen patients had restenosis of different degrees;the restenosis rates of 3 patients was more than 50 percent. The level of vWF 1 h and 6 months after CAS and the level of ET-1 1 h, 2 w and 6 months after CAS were increased rapidly as compared with those before CAS (P<0.05). As compared with those in the on-restenosis group, the level of vWF 1 h, 2 w and 6 months after CAS and the level of ET-1 1 h, 2 w, 1 and 6 months after CAS in the restenosis group were obviously increased (P<0.05). Conclusion The levels of vWF and ET-1 increase continually in a short term (within 2 weeks) after CAS, and increase once again 6 months after CAS which increases the risk of restenosis.Monitoring the levels of vWF and ET-1 may be of great value in judging long-term prognosis.