| 姜 超,黎传清,李林森,张 桐,李 祥.不同时机颈动脉内膜切除术对症状性颈动脉狭窄患者血清MCP-1、TIMP-1、Lp-PLA2的影响[J].,2025,(1):93-98 |
| 不同时机颈动脉内膜切除术对症状性颈动脉狭窄患者血清MCP-1、TIMP-1、Lp-PLA2的影响 |
| Effects of Carotid Endarterectomy at Different Times on Serum MCP-1, TIMP-1 and Lp-PLA2 in Patients with Symptomatic Carotid Stenosis |
| 投稿时间：2024-08-21 |
| DOI：10.13241/j.cnki.pmb.2025.01.013 |
| 中文关键词: 手术时机 颈动脉内膜切除术 症状性颈动脉狭窄 MCP-1 TIMP-1 Lp-PLA2 |
| 英文关键词: Timing of surgery Carotid endarterectomy Symptomatic carotid stenosis MCP-1 TIMP-1 Lp-PLA2 |
| 基金项目:江苏省自然科学基金项目（BK20181152） |
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| 中文摘要: |
| 摘要 目的：观察不同时机颈动脉内膜切除术（CEA）对症状性颈动脉狭窄患者血清单核细胞趋化因子-1（MCP-1）、基质金属蛋白酶组织抑制因子-1（TIMP-1）、脂蛋白相关磷脂酶A2（Lp-PLA2）的影响。方法：收集我院2020年2月至2023年2月期间行单侧CEA治疗的症状性颈动脉狭窄患者112例。根据患者第一次出现症状的时间直至行CEA的时间分为早期手术组（2w内手术，59例）和推迟手术组（2w后手术，53例）。对比两组常规评分、脑血流动力学指标、血清MCP-1、TIMP-1、Lp-PLA2，同时随访不良事件发生率。结果：两组术后12个月美国国立卫生院卒中量表（NIHSS）评分下降，且早期手术组NIHSS评分低于推迟手术组（P<0.05）。两组术后5 d大脑中动脉平均流速（MVMCA）、搏动指数（PI）升高，且早期手术组MVMCA、PI高于推迟手术组（P<0.05）。两组术后5 d血清MCP-1、TIMP-1、Lp-PLA2水平下降，且早期手术组血清MCP-1、TIMP-1、Lp-PLA2水平低于推迟手术组（P<0.05）。早期手术组的不良事件总发生率低于推迟手术组（P<0.05）。结论：CEA可明显改善症状性颈动脉狭窄患者脑血流动力学，调节血清MCP-1、TIMP-1、Lp-PLA2水平，减轻机体神经功能损伤，且早期手术效果相对更佳。 |
| 英文摘要: |
| ABSTRACT Objective: To observe the effects of carotid endarterectomy (CEA) at different times on serum monocyte chemoattractant protein-1 (MCP-1), tissue inhibitor of metalloproteinase-1 (TIMP-1) and lipoprotein-associated phospholipase A2 (Lp-PLA2) in patients with symptomatic carotid stenosis. Methods: A total of 112 patients with symptomatic carotid stenosis who underwent unilateral CEA treatment in our hospital from February 2020 to February 2023 were collected. According to the time from the first onset of symptoms to the time of CEA, the patients were divided into early surgery group (2w surgery, 59 cases) and delayed surgery group (2w surgery, 53 cases). The routine scores, cerebral hemodynamic indexes, serum MCP-1, TIMP-1 and Lp-PLA2 were compared between the two groups, and the incidence of adverse events was followed up. Results: The National Institutes of Health Stroke Scale (NIHSS) scores of the two groups decreased 12 months after operation, and the NIHSS score of the early operation group was lower than that of the delayed operation group (P<0.05). The mean velocity of middle cerebral artery (MVMCA) and pulsatility index (PI) of the two groups increased 5 days after operation, and the MVMCA and PI of the early operation group were higher than those of the delayed operation group (P<0.05). The levels of serum MCP-1, TIMP-1 and Lp-PLA2 in the two groups decreased 5 days after operation, and the levels of serum MCP-1, TIMP-1 and Lp-PLA2 in the early operation group were lower than those in the delayed operation group (P<0.05). The total incidence of adverse events in the early operation group was lower than that in the delayed operation group (P<0.05). Conclusion: CEA can significantly improve cerebral hemodynamics in patients with symptomatic carotid artery stenosis, regulate serum MCP-1, TIMP-1, Lp-PLA2 levels, and reduce neurological damage, and the effect of early surgery is relatively better. |
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