Research on the progression mechanism in arteriosclerotic lesion at the cervical and cerebral artery

颈脑动脉粥样硬化病变进展机制的研究

• 批准号: 18390403
• 负责人: OGAWA Akira
• 金额: $ 10.02万
• 依托单位: Iwate Medical University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (B)
• 财政年份: 2006
• 资助国家: 日本
• 起止时间: 2006 至 2007
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-18390403/
• 关键词: Arterial sclerosis; Cervical carotid artery stenosis; Cerebral artery stenosis; Oxidative stress; Free radical; MRI; Phenotinic modulation; transcrintion factor; 頚部内頚動脈狭窄; 脳循環; 一塩基多型; 血管平滑筋細胞

OBJECTIVE: Approximately 20 to 30% of patients undergoing carotid endarterectomy (CEA) subsequently develop cognitive impairment The purpose of the present study is to determine whether or not malondialdehyde (MDA)-modified low-density lipoprotein (LDL), a biochemical marker of oxidative damage, concentrations in the jugular bulb during CFA correlates with development of postoperative cognitive impairment. METHODS: Fifty-five patients undergoing CEA were assessed with a battery of neuropsychological tests before and 1 month after surgery. Serum samples for measurement of MDA-LDL concentration were obtained from a venous catheter inserted into the ipsilateral jugular bulb at the following time points: immediately before clamping of the internal carotid artery (ICA), 10 minutes after clamping of the ICA, and 5 and 20 minutes after declamping of the ICA RESULTS: The MDA-LDL concentrations at 5 and 20 minutes after ICA declamping were both significantly higher than concentrations before IC … More Aclamping (P < 0.0001). At the postoperative neuropsychological assessment, six (11%) out of 55 patients showed postoperative cognitive impairment Logistic regression analysis demonstrated that higher values of MDA-LDL increase (calculated as a percentage of the preclamp values)at either 5 or 20 minutes after ICA declamping were significantly associated with the development of postoperative cognitive impairment(95% confidence interval, 0.787-0.981; P = 0.0209)among the variables tested. CONCLUSION: MDA-LDL concentration in the jugular bulb during CEA correlates with development of postoperative cognitive impairmentBACKGROUND AND PURPOSE: The purpose of the present study was to determine whether preoperative cerebral hemodynamic impairment and reactive oxygen species produced during carotid endarterectomy (CEA) correlate with development of postoperative cerebral hyperperfusion. METHODS: Concentrations of malondialdehyde-modified low-density lipoprotein (MDA-LDL), a biochemical marker of oxidative damage, were measured in serum samples obtained from 90 patients undergoing CEA for ipsilateral ICA stenosis (>70%). Serum samples were obtained from a venous catheter inserted into the ipsilateral jugular bulb before clamping of the internal carotid artery (ICA), 10 minutes after clamping of the ICA, and 5 and 20 minutes after declamping of the ICA. Cerebral blood flow (CBF) and cerebrovascular reactivity (CVR) to acetazolamide were also measured using single-photon emission computed-tomography before CEA In addition, CBF was measured postoperatively. RESULTS: Hyperperfusion (CBF increase >100% compared with preoperative values)was observed immediately after CEA in 12 patients (13%). logistic regression analysis demonstrated that reduced preoperative CVR (95% CIs, 1.053 to 1.453; P=0.0097) and an increase in MDA-LDL (calculated as a percentage of the preclamp values) after. ICA declamping (95% Cis, 0.862 to 0.980; P=0.0098) were significantly associated with development of postoperative cerebral hyperperfusion among the variables tested. Ten of 11 patients with reduced preoperative CVR and increased MDA-LDL after ICA declamping developed post-CEA hyperperfusion, and 2 of these patients developed cerebral hyperperfusion syndrome. CONCLUSIONS: Both preparative cerebral hemodynamic impairment and reactive oxygen species produced during surgery correlate with development of cerebral hyperperfusion after CEA. Less

目的：在接受颈动脉内膜切除术(CEA)的患者中，约有20%至30%的患者随后发生认知功能障碍。本研究的目的是确定颈静脉球内氧化损伤的生化标志物丙二醛(MDA)修饰的低密度脂蛋白(LDL)浓度是否与术后认知功能障碍的发生有关。方法：对55例接受CEA手术的患者在术前和术后1个月进行一系列神经心理测试。分别于颈内动脉阻断前、阻断颈内动脉后10分钟、开放颈内动脉后5分钟和20分钟采血测定血清中丙二醛-低密度脂蛋白的浓度。结果：颈内动脉阻断后5分钟和20分钟的血清丙二醛-低密度脂蛋白浓度均显著高于IC-…前水平。更多限制(P&lt；0.0001)。在术后神经心理学评估中，55例患者中有6例(11%)出现术后认知功能障碍。Logistic回归分析显示，颈内动脉开放后5分钟或20分钟的丙二醛-低密度脂蛋白升高(以钳夹前值的百分比计算)与术后认知功能障碍的发生显著相关(95%可信区间为0.787~0.981；P=0.0209)。结论：CEA术中颈静脉球内丙二醛-低密度脂蛋白水平与术后认知功能障碍的发生密切相关。背景与目的：本研究旨在探讨颈动脉内膜剥脱术(CEA)术前脑血流动力学损害及颈动脉内膜剥脱术(CEA)时产生的活性氧与术后脑高灌流的关系。方法：对90例同侧颈内动脉狭窄(70%)患者行颈总动脉CEA手术，测定氧化损伤的生化标志物--丙二醛修饰的低密度脂蛋白(MDA-LDL)浓度。分别在夹闭颈内动脉(ICA)前、夹闭ICA后10min、ICA开放后5min和20min，从同侧颈静脉球内插入静脉导管采集血清样本。CEA前应用单光子发射计算机断层扫描测定脑血流量(CBF)和对乙酰唑胺的脑血管反应性(CVR)，术后测定CBF。结果：12例(13%)患者CEA术后即刻出现高血流灌注(CBF较术前增加100%)。Logistic回归分析显示，术前血管阻力降低(95%顺应值，1.053~1.453；P=0.0097)，术后丙二醛-低密度脂蛋白升高(以钳制前数值的百分比计算)。在所测试的变量中，颈内动脉去梗阻(95%顺应性，0.862~0.980；P=0.0098)与术后脑高灌注量的发生显著相关。术前CVR降低、ICA开放后MDA-LDL升高的11例患者中，有10例发生CEA术后高灌注，其中2例出现脑高灌注综合征。结论：预备性脑血流动力学损害和术中产生的活性氧与CEA术后脑高灌流的发生密切相关。较少

项目成果

Wrap-clipping with polytetrafluoroethylene for ruptured blisterlike aneurysms of the internal carotid artery

• DOI: 10.3171/jns.2006.105.5.785
• 发表时间: 2006-11-01
• 期刊: JOURNAL OF NEUROSURGERY
• 影响因子: 4.1
• 作者: Kubo, Yoshitaka;Ogasawara, Kuniaki;Ogawa, Akira
• 通讯作者: Ogawa, Akira

Trapping and vascular reconstruction for ruptured fusiform aneurysm in the peoximal Al segment of the anterior cerebral artery -case report

大脑前动脉邻端Al段破裂梭形动脉瘤的诱捕及血管重建-病例报告

• 发表时间: 2006
• 期刊: Neurologia medico-chirurgica 47
• 作者: Kuniaki;O;Kashimura H.;Yamazaki T.;Ishigaki D.;Fukuda T.;Kenji Y;Kashimura H.;Ogawa a.;Ogawa a.;Suga Y.;Saito H.;Fujiwara S.;Ogasawara K.;Masanori K. et al.;Takaaki B. et al.;Hiroshi K. et al.;Ogasawara K.;Saito H.;Komoribayashi N.;Kashimura H.
• 通讯作者: Kashimura H.

Bypass surgery revisited.-Japanese EC-IC bypass traial.The JET Study-

重新审视搭桥手术。-日本 EC-IC 搭桥试验。JET 研究-

• 发表时间: 2007
• 作者: Akira;O;Ogawa A.
• 通讯作者: Ogawa A.

Japanese EC-IC Bypass Trial: JET Syudy

日本 EC-IC 旁路试验：JET Syudy

• 发表时间: 2007
• 作者: Akira;O;Ogawa A.;Ogawa A.;小笠原 邦昭;小川 彰;小笠原 邦昭;小笠原 邦昭;小笠原 邦昭;小笠原 邦昭;小笠原 邦昭
• 通讯作者: 小笠原 邦昭

動脈狭窄と脳楯環-頸部頸動脈血行再建術過灌流の臨床像

动脉狭窄与盾环-颈动脉血运重建过度灌注的临床表现

• 发表时间: 2007
• 作者: Akira;O;Ogawa A.;Ogawa A.;小笠原 邦昭;小川 彰;小笠原 邦昭;小笠原 邦昭;小笠原 邦昭;小笠原 邦昭;小笠原 邦昭;小笠原 邦昭
• 通讯作者: 小笠原 邦昭