Effects Of Vascular Endothelium Function In Patients With Ischemic Cerebrovascular Disease After Interventional Therapy

Objective:1. Levels of plasma endothelin-1, nitrogen oxide and Von Willebrand factor of patients with ischemic cerebrovascular disease were investigated. Describe these active substances the significance and role in the development of ischemic cerebrovascular disease.2. The aim of this study was to investigate the effects of interventional therapy on vascular endothelium function. Plasma levels of ET-1, NO and vWF were measured before and immediately as well as24hours after DSA and PTAS. To explain the variation of plasma endothelial active substances after PTAS, to investigate the effects of interventional therapy on vascular endothelium function.3. Plasma levels of endothelial active substances were compared in different groups and subgroups both before and after interventional therapy, to study the relationships between the surgical approach, the number as well as the position of stent implantation with the degree of vascular endothelial injury.Methods:1.Subjects:This study involved191patients with ischemic cerebrovascular disease, who were admitted between April and October2011 and underwent PTAS or DSA. And the patients have the diseases such as inflammation, severe liver and kidney diseases, autoimmune diseases, blood diseases and malignant tumors were precluded.40healthy people who take a health examination in the same period were chosen as control group.2.Groups:The case group was divided into DSA group and PTAS group according to the pattern of the surgical approach. Stent subgroups were divided:①According to the number of stent implantation, the patients were divided into single stent group and multiple stent group.②According to the position of stent implantation, the patients were divided into intracranial group and extracranial group.3. Plasma levels of ET-1, NO and vWF were measured by enzyme linked immunosorbent assay in85patients before and immediately as well as24hours after DSA and PTAS.4. Statistical Analysis:The statistical analysis was executed by SPSS13.0software, using t-test chi-square test and analysis of variance for statistical, statistically significant level was "a=0.05"Results:1. Compared with the control group, case group has higher plasma levels of ET-1and vWF, but has lower plasma levels of NO. The prevalence of hypertension and diabetes, serum TCHO and LDL levels in case group are significantly higer then those in control group, however, the serum HDL level was lower then control group.2. Plasma levels of ET-1significantly increased immediately and24hours after DSA compared with before DSA. NO levels showed significant decrease immediately after the procedure compared with before the procedure. The change of plasma level of vWF was not observed during the procedure. Plasma levels of ET-1and vWF significantly increased immediately and24hours after PTAS compared with before PTAS. NO levels showed significant decrease immediately and24hours after the procedure compared with before the procedure. There was no significant difference of plasma ET-1, vWF, NO levels between DSA group and PTAS group before the procedure. While PTAS group has higer ET-1and vWF, lower NO immediately and24hours after the procedure.3. The plasma levels of ET-1, NO and vWF before PTAS between single stent group with multiple stent group and intracranial group with extracranial group showed no significant deviation. Compared with the single stent group, the patients in multiple stent group not only exhibited significantly higher plasma levels of ET-1and vWF but also showed greater ET-1, vWF, NO variation after PTAS. Single stent single stent group showed higher plasma level of ET-124hours after PTAS.Conclusion:l.The plasma levels of ET-1and vWF in patients with ischemic cerebrovascular disease increased, but level of NO decreased.2. The marked increase ET-1and decrease NO plasma levels after DSA probably related to endothelial injury by the DSA. The marked increase ET-1, vWF and decrease NO plasma levels after PTAS probably related to endothelial injury by the procedure. Compared with DSA, PTAS may has a greater degree of vascular endothelial damage. Multiple stent group suffered greater postoperative damage of the vascular endothelium. Compared with extracranial stent insertion, intracranial stent insertion may have greater injury to vascular endothelium.