Relation Of Hemodynamic Depression Due To Carotid Artery Stenting And Serum Selectins

Objective:ln this study,serum P-selection and E-selection and L-selection levels in receiving Carotid Artery Stenting(CAS) patients to analysis the risk factors of hemodynamic depression due to CAS.To investigate relation and clinical significance of hemodynamic depression due to CAS and the risk factors of hemodynamic depression and serum selectins.Methods:We inwestigated 60 patients with internal carotid artery stenosis receiving CAS as the experimental group and 30 healthy people as the control group from the General Hospital of Shenyang Military Region in this study.The study period was June 2012 to December 2014.According to internal carotid artery stenosis degree was determind by Digital subtraction angiography(DSA),the 60 patients were divided into two subgroup:moderate stenosis degree of the internal carotid artery group(50% 《stenosis degree《70%)36 cases,including 28 patient using balloon pre-expanding stenting and 8 patient using ballon dilatation stenting; severe stenosis degree of the internal carotid artery group(stenosis degree>70%)24 cases,including 5 patient using balloon pre-expanding stenting and 19 patient using ballon dilatation stenting.The two groups were comparable in age,gender and other general information. Retrospective analysis the risk factors of hemodynamic depression due to CAS.peripheral blood 4ml of the control group patients were collected and peripheral blood 4ml of the experimental group patients during before CAS、after DSA and after CAS.By enzyme-linked immunosorbent assay (ELISA) to detect serum P-selection、E-selection and L-selection levels.Using statistical software SPSS 17.0 statistical date on income.The results were showed in a way of x±s,the two groups were compared using t test,among groups were compared using ANOVA,categorical variables were compared using the x2 test,level date Spearman correlation analysis with nonparametric methods,multivariate logistic regression analysis,P<0.05 was considered statistically significant.Restlts:1. Serum P-selection,E-selection and L-selection levels of hemodynamic depression group was higher than those without hemodynamic depression group,the difference was statistically significant (P<0.05).By logistic regression analysis ballon dilatation stenting and severe stenosis degree of the internal carotid artery are the risk factors of hemodynamic depression due to CAS,the difference was statistically significant (P<0.05).2. Serum P-selection,E-selection and L-selection levels of severe stenosis degree of the internal carotid artery group was significantly higher than moderate stenosis degree of the internal carotid artery group and the control group,the difference was statistically significant (P<0.05). The levels of three serum selectins showed stenosis of the internal carotid artery positively correlated and there was a positive correlation between the three selectins’level.3. Compare three serum selections levels of the experimental group DSA before and after,the difference was not statistically significant (P>0.05).The serum P-selection,E-selection and L-selection levels in patients of the experimental group after received CAS ware significantly higher than the before received CAS and the control group,the difference was statistically significant (P<0.05). The serum E-selection levels of the ballon dilatation stenting group ware significantly higher than balloon pre-expanding stenting group,the difference was statistically significant (P<0.05).Conclusion:1. By logistic regression analysis ballon dilatation stenting and severe stenosis degree of the internal carotid artery are the risk factors of hemodynamic depression due to CAS;Hemodynamic depression due to CAS,ballon dilatation stenting and severe stenosis degree of the internal carotid artery are closely associated with serum selections levels.There may be prompted new ideas to select inhibitors for the prevention of hemodynamic depression due to CAS so as to reduce the adverse effects on hemodynamic depression due to CAS after treatment.2. Three serum selectins levels may predict the internal carotid artery degree.3. The serum P-selection,E-selection and L-selection levels in patients of the experimental group after received CAS ware significantly higher than the before received CAS and the control group,showed elevated levels of the three serum selectins involved CAS to endothelial mechanical injury on occurrence and development process.