糖尿病合并颈动脉狭窄患者的血管内支架置入术疗效评估

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1、中国图书资料分类号:R743.33学号：10660S090303贵阳医学院2012届临床医学硕士专业学位材料(临床论文部分)糖尿病合并颈动脉狭窄患者的血管内支架置入术疗效评估研究生：王黎洲导师：李兴教授年级：2009级专业：影像医学与核医学2012年5月12日基金项目：贵州省省长专项基金资助项目编号2007_75号贵阳医学院2012届硕士学位论文目录摘要„„„„„„„„„„„„„„02英文摘要„„„„„„„„„„„„„„03缩略词„„„„„„„„„„„„„„„04前言„„„„„„„„„„„„„„05资料与方法„„„„„„„„„„„„„07结果„„„„„„„„„„„„„„10讨论„„„

2、„„„„„„„„„„„12结论„„„„„„„„„„„„„„17参考文献„„„„„„„„„„„„„„18附图„„„„„„„„„„„„„„21论文原创性声明„„„„„„„„„„„„29致谢„„„„„„„„„„„„„„30综述„„„„„„„„„„„„„311贵阳医学院2012届硕士学位论文糖尿病合并颈动脉狭窄患者的血管内支架置入术疗效评估专业：影像医学与核医学，研究生：王黎洲，导师：李兴教授【摘要】目的探讨并评估颈动脉支架置入术(CAS)在预防糖尿病合并颈动脉狭窄患者发生脑梗塞及改善生活质量方面的远期效果。方法选择我科2002年至2010年接受CAS治疗的糖尿病合并颈动脉狭窄患者39例，定

3、期随访1-6年。复查颈部血管彩超、头部MRI、头部CT及灌注成像，并对28例症状性颈动脉狭窄患者术前、术后第14天、3个月、6个月进行NIHSS、BI、MRS量表评分，最后对评分、影像学检查结果、发生缺血性脑血管事件的情况等进行分析比较。结果39例接受CAS治疗的糖尿病合并颈动脉狭窄患者，随访1-6年，平均33个月，3例患者(7．7％)出现终点事件均为脑梗塞。其中2例(66.7％)患者缺血事件对应的脑梗塞发生在支架置入同侧．1例(33.3％)所对应的脑梗塞发生在支架置入对侧。28例症状性狭窄患者CAS治疗后14天、3个月NIHSS、MRS量表评分均术前显著降低(P<0．05)，治疗后

4、3个月、6个月BI量表评分均较术前显著增多(P<0．05)。进行单因素分析比较，高龄（年龄>75岁）、有高血压史、存在两个以上脑血管疾病的危险因素、CAS术后未按系统且规律地服用抗血小板药物以及术前发生过多次脑梗塞病史的患者术后易发生缺血性脑血管终点事件(P<0．05)。有3例(7．7％)患者术后发生了再狭窄的事件。结论对于糖尿病合并颈动脉狭窄的患者CAS治疗是安全的，能显著地降低脑卒中的发生风险及改善患者的生活质量。CAS术后中远期再狭窄发生率较低，随访效果较为满意。【关键词】糖尿病；颈动脉狭窄；支架；疗效第2页贵阳医学院2012届硕士学位论文Theefficacyevaluati

5、onofcarotidarterystentingforDiabeticpatientswithcarotidstenosisWangLi-Zhou,Major:ImagingandNuclearMedicine,TheAffiliatedHospitalofGuiyangMedicalCollege,Guiyang,Guizhou,550004【Abstract】ObjectToevaluatecarotidarterystenting(CAS)inpreventionoftheoccurrenceofcerebralinfarctionandimprovethequalityof

6、lifelong-termeffectindiabeticpatientswithcarotidstenosis.MethodsThirty-ninediabeticpatientswhohadreceivedCASandfinish1-6yearsfollow-upinourdepartmentfrom2002to2010wereenrolledassubjects．thescore,imagingfindingsandtheoccurrenceofischemiccerebrovasculareventswerecomparedandanalyzed.ResultsDuringt

7、he1-6years(Anaverageof33months)follow-up。threepatients(7．7％)hadrecurrentischemicevents．OftheThreerecurrentpatients。Tow(66.7％)hadinfarctionsipsilateralastheCAS；andOne(33.3％)hadinfarctioncontralateraltotheCAS。Twenty–eightpatientswit