本文選題：顱外頸動(dòng)脈　切入點(diǎn)：血流動(dòng)力學(xué)　出處：《中國(guó)老年學(xué)雜志》2017年17期 　論文類型：期刊論文

【摘要】：目的探討顱外頸動(dòng)脈血流動(dòng)力學(xué)改變對(duì)預(yù)測(cè)老年顱內(nèi)動(dòng)脈狹窄的價(jià)值及免疫學(xué)機(jī)制。方法選取2016年1~6月確診為顱內(nèi)動(dòng)脈中、重度狹窄的老年患者92例為研究組;同期收治的無(wú)腦血管病或僅存在輕度腦動(dòng)脈硬化的老年患者42例為對(duì)照組,用超聲檢查兩組顱外頸動(dòng)脈血流動(dòng)力學(xué)參數(shù)。收集兩組靜脈血分離外周血單個(gè)核細(xì)胞(PBMC),流式細(xì)胞術(shù)檢測(cè)Th1、Th2、Th17細(xì)胞比例。結(jié)果研究組顱內(nèi)前循環(huán)狹窄患者PSV頸總動(dòng)脈(CCA)、EDVCCA、PSVICA、EDVICA、PSVICA/PSVCCA均明顯低于對(duì)照組,RIVCCA、RIICA明顯高于對(duì)照組(P0.05);EDVCCA、PSVICA、RIVCCA、EDVICA預(yù)測(cè)顱內(nèi)前循環(huán)狹窄的準(zhǔn)確性較高。研究組后循環(huán)狹窄患者PSVVA、EDVVA、MPSVVA、MEDVVA均明顯低于對(duì)照組,RIVA、MRIVA明顯高于對(duì)照組(P0.05);PSVVA、EDVVA、RIVA預(yù)測(cè)顱內(nèi)后循環(huán)狹窄的準(zhǔn)確性較高。研究組PBMC中Th1、Th17細(xì)胞比例明顯高于對(duì)照組(P0.01);兩組Th2細(xì)胞比例差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);研究組頸動(dòng)脈重度狹窄患者PBMC中Th1、Th17細(xì)胞比例明顯高于中度狹窄者(P0.05)。結(jié)論超聲分析頸動(dòng)脈血流動(dòng)力學(xué)參數(shù)可有效預(yù)測(cè)顱內(nèi)前、后動(dòng)脈狹窄;Th1與Th17細(xì)胞介導(dǎo)的免疫機(jī)制參與顱內(nèi)動(dòng)脈狹窄的發(fā)生、發(fā)展過(guò)程。
[Abstract]:Objective to investigate the value and immunological mechanism of extracranial carotid artery hemodynamic changes in predicting intracranial artery stenosis in the elderly. Methods 92 elderly patients with severe stenosis from 2016 to June were selected as the study group. 42 elderly patients with no cerebrovascular disease or only mild cerebral arteriosclerosis were treated as control group. The hemodynamic parameters of extracranial carotid artery were examined by ultrasound. Peripheral blood mononuclear cells were isolated from peripheral blood mononuclear cells (PBMC) in both groups, and Th1 Th2Th2Th17 cells were detected by flow cytometry. Results the common carotid artery of PSV in patients with intracranial anterior circulation stenosis was detected by flow cytometry. The accuracy of predicting intracranial anterior circulation stenosis in patients with posterior circulation stenosis in the study group was significantly lower than that in the control group (P < 0.05). The prediction of intracranial anterior circulation stenosis in the study group was significantly lower than that in the control group (P < 0.05). The prediction of intracranial anterior circulation stenosis in the study group was significantly lower than that in the control group (P < 0.05), and the prediction of posterior circulation stenosis in the study group was significantly lower than that in the control group (P < 0.05). The prediction of intracranial posterior circulation stenosis in the study group was significantly lower than that in the control group (P < 0.05), and it was significantly higher in the study group than that in the control group (P < 0.05). The prediction of intracranial anterior circulation stenosis in the study group was significantly lower than that in the control group (P 0.05). The prediction of intracranial posterior circulation stenosis in the study group was significantly lower than that in the control group (P 0.05). The percentage of Th1 Th17 cells in PBMC in study group was significantly higher than that in control group (P 0.01), there was no significant difference in the proportion of Th2 cells between the two groups (P 0.05) and the proportion of Th1 Th17 cells in PBMC in patients with severe stenosis of carotid artery in study group was significantly higher than that in patients with moderate stenosis. Conclusion Ultrasound analysis of carotid hemodynamic parameters can effectively predict the intracranial anterior. The immune mechanism mediated by Th1 and Th17 cells is involved in the occurrence and development of intracranial artery stenosis.
【作者單位】： 承德市中心醫(yī)院超聲診斷科;
【基金】：承德市科學(xué)技術(shù)研究與發(fā)展計(jì)劃項(xiàng)目課題(No.20151004)
【分類號(hào)】：R445.1;R743.3

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