低频超声治疗动脉粥样硬化性大脑中动脉狭窄急性脑梗死患者的疗效及对炎症指标的影响分析

目的:探讨低频超声治疗动脉粥样硬化性大脑中动脉(MCA)狭窄急性脑梗死(ACI)患者的临床疗效及对炎症指标的影响。方法:选取2015年10月至2018年5月华中科技大学同济医学院附属荆州医院收治的动脉粥样硬化性MCA狭窄ACI患者82例,按随机数字表法分为对照组和观察组,每组各41例。对照组行常规治疗,观察组在对照组的基础上行低频超声治疗,对所有患者治疗前及治疗14 d后的神经功能进行评分,低频超声检测MCA狭窄段峰值血流速度(Vs)、微栓子信号(MES)阳性率,比较治疗前、治疗7 d后、14 d后两组患者血清高敏C-反应蛋白(hs-CRP)水平。结果:治疗14 d后两组的美国国立卫生研究院卒中量表(NIHSS)评分下降,且观察组较对照组NIHSS评分更低(P0.05);治疗14 d后观察组MCA狭窄段Vs低于治疗前(P0.05),而对照组与治疗前比较无统计学差异(P0.05)。治疗7 d后、14 d后观察组MES阳性率均低于对照组(P0.05)。两组治疗7 d后、14 d后hs-CRP水平低于治疗前,且治疗14 d后低于治疗7 d后(P0.05);而观察组治疗7 d后、14 d后hs-CRP水平低于对照组(P0.05)。结论:低频超声治疗动脉粥样硬化性MCA狭窄ACI患者疗效显著,可改善神经功能与炎症反应,减缓Vs,提高动脉粥样硬化斑块的稳定性。

Curative Effect of Low Frequency Ultrasound in the Treatment of Atherosclerotic Middle Cerebral Artery Stenosis in Patients with Acute Cerebral Infarction and Its Influence on Inflammatory Markers

ABSTRACT Objective: To investigate the clinical effect of low frequency ultrasound in the treatment of atherosclerotic middle cerebral artery(MCA) stenosis in patients with acute cerebral infarction(ACI) and its influence on inflammatory markers. Methods: 82 ACI patients with atherosclerotic MCA stenosis treated in Jingzhou Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from October 2015 to May 2018 were selected, they were divided into the control group and the observation group according to the random number table method, 41 cases in each group. The control group received routine treatment, while the ob- servation group accepted low frequency ultrasound based on the control group. The neurological function scores of all patients were eval- uated before treatment and 14 d after treatment. MCA stenosis segment peak blood flow velocity(Vs) and micro embolic signal (MES) positive rate were detected by low frequency ultrasound. The levels of serum high sensitive C- reactive protein(hs-CRP) in the two groups were compared before treatment, 7 d, 14 d after treatment. Results: The National Institutes of Health Stroke Scale(NIHSS) scores de- creased in the two groups at 14 d after treatment, and the NIHSS scores in the observation group were lower than that in the control group (P<0.05). 14 d after treatment, MCA stenosis segment Vs in the observation group was lower than before treatment (P<0.05), while there was no significant difference between the control group and before treatment (P>0.05). 7 d, 14 d after treatment, the positive rate of MES in the observation group was lower than that in the control group (P<0.05). 7 d, 14 d after treatment, the level of hs-CRP was lower than before treatment, and at 14 d treatment was lower than that at 7 d after treatment (P<0.05). The level of hs-CRP at 7 d, 14 d after treatment in the observation group was lower than that in the control group(P<0.05). Conclusion: The efficacy of low frequency ultrasound in the treatment of atherosclerotic MCA stenosis ACI patients is significant.It can improve the nerve function and inflammatory reaction, slow down the Vs and improve the stability of atherosclerotic plaque.