CAS和CEA治疗颈内动脉重度狭窄疗效及对脑血流量、血清miR-145、IGF1R的影响

目的:探讨颈动脉支架植入术(CAS)和颈动脉内膜剥脱术(CEA)治疗颈内动脉重度狭窄疗效及对脑血流量、血清miR-145、胰岛素样生长因子1受体(IGF1R)的影响.方法:回顾性分析2018年1月至2019年12月我院收治的100例颈动脉重度狭窄患者的临床资料,按照手术方式不同分为A组和B组,每组50例,A组给予CAS...

Effects of CAS and CEA on Cerebral Blood Flow, Serum miR-145 and IGF1R in Treatment of Severe Internal Carotid Artery Stenosis

Objective:To study the effects of carotid artery stenting(CAS)and carotid endarterectomy(CEA)on cerebral blood flow,serum miR-145 and insulin-like growth factor 1 receptor(IGF1R)in treatment of severe internal carotid artery stenosis.Methods:The clinical data of 100 patients with severe carotid stenosis admitted to our hospital from January 2018 to December 2019 were retrospectively analyzed,they were divided into A group and B group according to different operative methods,50 cases in each group,the A group was given CAS treatment,and the B group received CEA treatment.The perioperative conditions,cerebral blood flow,serum miR-145,IGF1R,Mini Mental State Examination(MMSE)and Montreal Cognitive Assessment Scale(MoCA)were compared between the two groups,and the postoperative complications,restenosis rate and mortality rate were compared.Results:There was no significant difference in operation time,intraoperative blood loss,postoperative mechanical ventilation time,ICU stay time and hospitalization time between the two groups(P>0.05);at postoperative 30 days,there were no significant differences in the relative time to peak(RTTP),relative mean transit time(rmtt),relative cerebral blood volume(rCBV),relative cerebral blood flow(rcbe),serum miR-145,IGF1R,MMSE scale and MOCA scale scores between the two groups(P>0.05);within postoperative 30 days,there was no significant difference in bradycardia,myocardial enzyme spectrum increased,hyperperfusion syndrome,local hematoma and acute carotid artery occlusion between the two groups(P>0.05);the incidence of stroke and hypotension in A group were significantly higher than that in B group,the incidence of hypertension in the B group was significantly higher than that in A group(P<0.05);at postoperative1 year,there was no significant difference in mortality and restenosis rate between the two groups(P>0.05).Conclusion:CAS and CEA have similar effects in the treatment of patients with severe internal carotid artery stenosis,they are can effectively improve cerebral blood flow,regulate the expression of serum miR-145 and IGF1R,and promote the recovery of cognitive function.However,the incidence of stroke and hypotension after CAS is higher,and the incidence of hypertension after CEA is higher.