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第66届血管年会:球囊成形术可改善MS患者的静脉血流

2012-06-17 陈蓉 爱唯医学网

        美国纽约Albany医学院的Manish Mehta博士在第66届血管年会上报告的一项初步研究显示,对于慢性脑静脉功能不全(CCSVI)的多发性硬化症(MS)患者,经皮球囊成形术可改善其血流动力学。 Dr. Manish Mehta           虽然近期发现M

        美国纽约Albany医学院的Manish Mehta博士在第66届血管年会上报告的一项初步研究显示,对于慢性脑静脉功能不全(CCSVI)的多发性硬化症(MS)患者,经皮球囊成形术可改善其血流动力学。

Dr. Manish Mehta
 
        虽然近期发现MS和以颅外静脉(包括颈内静脉和奇静脉)狭窄和反流为特征的CCSVI有关联,但关于采用经皮球囊成形术治疗这类狭窄是否合理仍存在较大争议。于是Mehta博士及其同事开展了这项研究,量化分析了经皮球囊成形术对这类病灶血流动力学的影响。

       研究者采用血管造影,对50例MS 合并CCSVI 患者的颈内静脉和12名健康志愿者的颈内静脉进行了评估。量化分析从颈内静脉中段到上腔静脉的造影剂飞跃时间,以及深静脉排空时间(PVET)。在球囊扩张术前后记录CCSVI患者的飞跃时间和PVET,对健康志愿者也记录这两项指标。

       结果显示,在50例颈内静脉狭窄超过70%、反流且接受球囊扩张术的CCSVI-MS患者中,44例(78%)技术成功(定义为颈内静脉残余狭窄不足20%)。研究者观察到,CCSVI患者在接受球囊扩张术后,飞跃时间和PVET均明显改善,达到与健康对照者相当的程度。

      上述结果提示,MS与CCSVI相关,后者导致飞跃时间和PVET异常升高。而且,对这类病变行球囊扩张术可改善血液动力学参数,达到与健康人可比的程度。

       Mehta博士强调,尚需开展随机研究以进一步澄清这一问题,并指出这一患者群易受安慰剂效应的影响。他还表示,这一治疗已在全球被用于很多患者,美国食品药品管理局(FDA)已发出警告,由于缺乏安全性和有效性数据,反对在严格控制的试验之外对这类患者使用该药。


编译自:Balloon Angioplasty Improves Venous Flow in MS Patients.Elsevier Global Medical News.6/11/2012 
 

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    2013-04-22 xue8602
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    2012-11-11 fusion
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    2012-06-19 花花1366
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