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颈动脉球囊扩张与支架置入术后血清一氧化氮和内皮素变化的实验与临床观察

Changes of nitric oxide and endothelin serum level after carotid balloon denudation or stent assisted angioplasty: an experimental and clinical observation

摘要:

目的:观察小型猪颈动脉球囊扩张前后和颈动脉狭窄患者狭窄扩张、支架置入术前后血清一氧化氮(NO)和内皮素(ET)的变化.方法:选取12头广西巴马小型猪,分别于颈动脉球囊损伤前、损伤后2周和3周检测静脉血血清中NO和ET的浓度.同样方法检测19例颈动脉狭窄患者支架置入术前、术后静脉血及支架置入处动脉血血清中NO和ET的浓度.结果:小型猪颈动脉损伤后2周NO浓度较损伤前显著降低(P<0.05),ET浓度较损伤前升高,但无显著差异;损伤后3周ET浓度明显升高(P<0.01).支架置入患者中,术前、术后即刻和术后6 h周围静脉血的NO浓度和同一时间点的ET浓度变化差异均尢统计学意义.结论:小型猪颈动脉球囊损伤后可观察到NO降低和ET升高,可能与猪颈动脉粥样硬化性狭窄的发生相关;人颈动脉狭窄支架置入术后NO、ET的变化及其在术后动脉冉狭窄中的作用尚需进一步研究.

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abstracts:

Objective To observe the changes of nitric oxide (NO) and endothelin (ET) serum level in the Guangxi BA-MA minipigs whose carotid arteries were injured by balloon denudation and in the patients with catotid stent assisted angioplasty. Methods Twelve Guangxi BA-MA minipigs were choosen. High fat/cholesterol feeding and endovascular balloon denudation were used to create a carotid artery atherosclerotic stenosis animal model. Blood samples were collected from peripheral veins before starting the procedure, and again, at 2 and 3 weeks after the procedure, respectively. Serum NO and ET concentrations of blood samples were tested. Nineteen patients with carotid artery stenosis who underwent stent assisted angioplasty were randomly selected, and their serum NO and ET were tested using the same methods as above. Results In the animal group, there was a significant decrease of mean NO concentration at 2 weeks after carotid injury (t-test, P<0.05 ), however, no significant change of ET was observed. A very significant increase of ET was observed at 3 weeks after the procedure (t-test, P <0.01 ). In the patient group, there were no significant differences among serum NO or ET concentration of peripheral vein blood before, immediately after, and 6 h after the endovascular treatment. Conclusions In this study, a decrease of NO concentration and an increase of ET concentration of peripheral vein blood are found in BA-MA minipigs after carotid arteries are injured by balloon denudation, which might be a cue for the formation of atherosclerosis. However, no significant changes are observed in this group of patients who underwet carotid angioplasty treatment. Therefore, further studies are needed.

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作者: 刘加春 [1] 王大明 [1] 钱江南 [2] 李雅国 [3] 王利军 [1] 姜学丽 [1] 翟乐乐 [1] 陆军 [1] 祁鹏 [1]
第一作者: 刘加春
期刊: 《中华外科杂志》2009年47卷6期 423-426页 MEDLINEISTICPKUCSCD
分类号: R5
栏目名称: 颈动脉粥样硬化性狭窄
DOI: 10.3760/cma.j.issn.0529-5815.2009.06.008
发布时间: 2009-05-12
基金项目:
国家自然科学基金 卫生部临床学科重点项目
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