【摘要】 目的探讨P选择素和血管性假血友病因子(vWF)及内皮素1在短暂性脑缺血发作(TIA)患者介入治疗术后的表达及意义。方法选择TIA患者67例,根据病变、手术复杂程度将患者分为A组(38例)和B组(29例),所有患者在颈动脉狭窄支架置入术前,术后1、6、24 h,2周测静脉血浆P选择素、vWF、内皮素1水平,并进行比较。结果与术前比较,TIA患者术后1、6、24 h,2周P选择素、内皮素1明显升高,术后1、6、24 h vWF明显升高;A组患者术后1、6 h P选择素和vWF明显升高,术后1、6、24 h内皮素1明显升高;B组患者术后各时间点P选择素、内皮素1明显升高,术后1、6、24 h vWF明显升高。与A组比较,B组患者术后各时间点内皮素1明显升高,术后1、6、24 h vWF明显升高(P<0.05,P<0.01)。结论 P选择素、vWF、内皮素1在颈动脉狭窄支架置入术后有一定程度的激活,并与病变程度、手术复杂程度有关;术后监测对患者危险分层、临床治疗及判断预后可能有重要价值。更多还原

【Abstract】 Objective To explore the expression and significance of plasma P-selectin(PS),von Willebrand’s factor (vWF) and endothelin-1 in patients with TIA after carotid artery stenting (CAS).Methods sixty-seven patients with TIA were divided into group A(38 cases)and group B (29 cases) according to pathologic change and complicate degree of CAS.The levels of PS,vWF and endothelin-1 before CAS and 1 hour,6 hours,24 hours,2 weeks after stenting were measured in all patients.Results The levels of PS and endothelin-1 increased obviously at 1 hour,6 hours, 24 hours and two weeks after CAS in the patients with TIA.The level of vWF increased obviously at 1 hour,6 hours and 24 hours after CAS.The levels of PS and vWF increased obviously at 1 hour and 6 hours after CAS and the level of endothelin-1 increased obviously at 1 hour,6 hours and 24 hours after CAS in the group A.The levels of PS and endothelin-1 increased obviously at every time point after CAS and the level of vWF increased obviously at 1 hour,6 hours and 24 hours after CAS in the group B.Compared with group A,the level of endothelin-1 increased obviously at every time point after CAS and the level of vWF increased obviously at 1 hour,6 hours and 24 hours after CAS in group B and there was statistical difference (P < 0.05,P < 0.01). Conclusion PS,vWF and endothelin-1 were activated to some extent after CAS and related to extent of pathological changes and complicate degree of CAS.Monitoring these biological indexes after CAS may be of great value to stratification of risk,clinical therapy and judgment of prognosis.更多还原