中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2014, Vol. 9 ›› Issue (23): 2095-2101.doi: 10.4103/1673-5374.147937

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

球囊扩张支架成形术支架置入治疗椎动脉开口重度狭窄：BOLD-fMRI验证对小脑脑功能重塑的影响？

  

  • 收稿日期:2014-11-01 出版日期:2014-12-10 发布日期:2014-12-10

Angioplasty and stenting for severe vertebral artery orifice stenosis: effects on cerebellar function remodeling verified by blood oxygen level-dependent functional magnetic resonance imaging

Bo Liu 1, 2, 3, Zhiwei Li1, Peng Xie 1, 2, 3, 4   

  1. 1 Department of Neurology, Yongchuan Hospital, Chongqing Medical University, Chongqing, China
    2 Institute of Neuroscience, Chongqing Medical University, Chongqing, China
    3 Chongqing Key Laboratory of Neurobiology, Chongqing Medical University, Chongqing, China
    4 Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
  • Received:2014-11-01 Online:2014-12-10 Published:2014-12-10
  • Contact: Peng Xie, M.D., Department of Neurology, Yongchuan Hospital, Chongqing Medical University, Chongqing 402160, China; Institute of Neuroscience, Chongqing Medical University, Chongqing 400016, China; Chongqing Key Laboratory of Neurobiology, Chongqing Medical University, Chongqing 400016, China; Department of Neurology, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China, xiepeng@cqmu.edu.cn.
  • Supported by:

    This study was supported by the Natural Science Foundation of Yongchuan District of Chongqing in China, No. Ycstc, 2013nc8031; the Foundation of Chongqing Municipal Health Bureau in China, No. 2010-2-250; the Foundation of Chongqing Health and Family Planning Commission in China, No. 20143001; the Soft Science Foundation of Yongchuan District of Chongqing in China, No. Ycstc, 2011BE5004.

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摘要：

椎动脉开口支架置入能明显改善小脑、脑干等后循环供血。但以往研究多重视介入治疗后后循环脑组织脑血流及脑灌注的恢复情况，本组研究首次在中国观察介入治疗前后以血氧水平依赖-功能磁共振成像（BOLD-fMRI）验证的局部脑组织功能恢复对小脑脑功能重塑的影响。选取40例单侧椎动脉开口重度狭窄患者，随机分为介入组和对照组，每组20例，对照组仅采用药物治疗，介入组采用椎动脉开口支架成形术和同对照组一致的药物治疗。治疗13 d后比较两组眩晕残障程度评定量表评分，并通过直观反应局部脑组织脑功能重塑、重组情况的BOLD-fMRI观察两组患者小脑脑功能重塑情况。发现介入组眩晕残障和小脑皮质脑功能改善程度均明显高于对照组，说明介入治疗椎动脉开口重度狭窄能有效地促进患者小脑脑功能重塑，有神经保护作用。

关键词: 神经再生, Posterior Circulation Ischemia, 椎-基底动脉供血不足, 眩晕, 眩晕残障程度评定量表, 椎动脉狭窄, 支架成形术, 血管内治疗, 功能磁共振成像, 脑功能重塑, 脑血管, 粥样斑块

Abstract:

Vertebral artery orifice stenting may improve blood supply of the posterior circulation of the brain to regions such as the cerebellum and brainstem. However, previous studies have mainly focused on recovery of cerebral blood flow and perfusion in the posterior circulation after interventional therapy. This study examined the effects of functional recovery of local brain tissue on cerebellar function remodeling using blood oxygen level-dependent functional magnetic resonance imaging before and after interventional therapy. A total of 40 Chinese patients with severe unilateral vertebral artery orifice stenosis were enrolled in this study. Patients were equally and randomly assigned to intervention and control groups. The control group received drug treatment only. The intervention group received vertebral artery orifice angioplasty and stenting + identical drug treatment to the control group. At 13 days after treatment, the Dizziness Handicap Inventory score was compared between the intervention and control groups. Cerebellar function remodeling was observed between the two groups using blood oxygen level-dependent functional magnetic resonance imaging. The improvement in dizziness handicap and cerebellar function was more obvious in the intervention group than in the control group. Interventional therapy for severe vertebral artery orifice stenosis may effectively promote cerebellar function remodeling and exert neuroprotective effects.

Key words: nerve regeneration, posterior circulation ischemia, vertebrobasilar insufficiency, dizziness, Dizziness Handicap Inventory, vertebral artery stenosis, angioplasty and stenting, endovascular treatment, functional magnetic resonance imaging, cerebellar function remodeling, cerebral vessels, atheromatous plaque, neural regeneration