远端血管通路导管治疗急性脑梗死对血清Adropin蛋白、载脂蛋白A1的影响

摘要 目的：探讨远端血管通路导管治疗急性脑梗死对血清Adropin蛋白、载脂蛋白A1（ApoA1）的影响。方法：将2018年6月到2021年4月选择在本院急诊的急性脑梗死患者84例作为研究对象，根据随机信封1:1抽签原则把患者分为导管组与支架组，各42例。支架组给予支架溶栓治疗，导管组给予远端血管通路导管治疗，比较两组手术相关指标、mTICI分级情况、脑血液流变学变化以及血清Adropin、ApoA1含量等指标。结果：导管组的导引导管到位时间、血管获得再通时间均较支架组少（P<0.05）；导管组治疗后1个月的血管灌注改良脑梗死溶栓试验（mTICI）分级优于支架组（P<0.05）；两组颅脑椎动脉与基底动脉血流速度治疗前均无差异（P>0.05），治疗后两组的颅脑椎动脉与基底动脉血流速度高于治疗前（P<0.05），导管组较支架组高（P<0.05）；两组血清Adropin、ApoA1含量治疗前对比无差异（P>0.05），治疗后两组的血清Adropin、ApoA1含量较治疗前高（P<0.05），导管组较支架组高（P<0.05）。结论：远端血管通路导管治疗急性脑梗死可加快手术操作改善患者的血管灌注分级情况，促进血清Adropin、ApoA1的释放，有利于患者脑动脉血流速度的恢复。

Effect of Distal Vascular Access Catheter in Treatment of Acute Cerebral Infarction on Serum Adropin Protein and Apolipoprotein A1

ABSTRACT Objective: To investigate the effects of distal vascular access catheters for treatment of acute cerebral infarction on serum Adropin protein and apolipoprotein A1 (ApoA1). Methods: From June 2018 to April 2021, 84 cases of patients with acute cerebral infarction in the emergency department of our hospital were selected as the research objects. All the cases were divided into catheter group and stent group with 42 cases each groups accorded to the random envelope 1:1 lottery principle. The stent group was given stent thrombolysis, and the catheter group was given distal vascular access catheter therapy. The operation-related indicators, mTICI grade, cerebral hemorheology changes, and serum Adropin and ApoA1 levels were compared between the two groups. Results: In the catheter group, the time to place the guiding catheter and the blood vessel recanalization were shorter than that of the stent group(P<0.05). The vascular perfusion modified mTICI of the catheter group were better than that of the stent group one month after treatment (P<0.05). There was no difference in craniocerebral and basilar flow velocity between the two groups before treatment (P<0.05), after treatment, the blood flow velocity of the craniocerebral vertebral artery and basilar artery were higher than before treatment(P<0.05), and the catheter group were higher than the stent group(P<0.05). There was no difference in serum Adropin and ApoA1 levels between the two groups before treatment(P<0.05), after treatment, the serum Adropin and ApoA1 levels in the two groups were higher than before treatment (P<0.05), and the catheter group were higher than the stent group(P<0.05). Conclusion: The treatment of acute cerebral infarction with distal vascular access catheter can speed up the operation and improve the vascular perfusion grading of patients, promote the release of serum Adropin and ApoA1, and help the recovery of cerebral arterial blood flow velocity.