【摘要】：背景與目的： 由于放射治療技術的進步和綜合治療的采用，鼻咽癌的治療效果有了一定的提高。放射性腦病、頸動脈損傷等各種并發(fā)癥的發(fā)生率隨之升高。本研究就鼻咽癌患者放療后頸動脈損傷的各影響因素及頸動脈狹窄與放射性腦病的關系進行探討。 方法： 將2011年1月至2012年2月隨診的113例接受過放療的鼻咽癌患者作為實驗組，并將29例初治診斷為鼻咽癌而未接受放療的患者作為對照組。采用彩色多普勒超聲觀察患者頸部動脈損傷情況，同時進行血糖、血脂及磁共振檢查，收集高血壓、吸煙、心腦血管事件等各因素資料。 結果： 兩組患者基本臨床資料無顯著差異。實驗組頸動脈損傷的發(fā)生率為50/113（44.25%），，顯著高于對照組的6/29（20.69%）（P=0.021）。頸內、頸總動脈損傷較對照組更常見（P分別為0.026，0.046）。頸動脈狹窄≥50%僅見于實驗組（9.73%：0%），但兩組無顯著差異。Logistic多因素回歸分析發(fā)現(xiàn)放療間隔時間（5年）、年齡（50歲）是頸動脈損傷和狹窄≥50%的獨立危險因素。放療5年以上患者的頸動脈、頸總動脈狹窄發(fā)生率顯著高于對照組。反復排除偏倚因素進行分析，頸動脈狹窄≥50%與放射性腦病的相關性尚不明確。 結論： 鼻咽癌放療可導致頸動脈損傷，而且損傷多見于頸內、頸總動脈。頸動脈損傷可能開始于放療后的3至5年。年齡50歲、放療間隔5年以上是頸動脈損傷和狹窄的獨立危險因素。頸動脈狹窄≥50%與放射性腦病的相關性需要進一步研究。鼻咽癌放療長期生存的患者行頸部血管彩超篩查是有必要的。
[Abstract]:Background & objective: the therapeutic effect of nasopharyngeal carcinoma (NPC) has been improved due to the progress of radiotherapy technology and the use of comprehensive therapy. The incidence of radiation encephalopathy, carotid artery injury and other complications increased. In this study, the influence factors of carotid artery injury after radiotherapy and the relationship between carotid stenosis and radiation encephalopathy in patients with nasopharyngeal carcinoma (NPC) were studied. Methods: 113 NPC patients who received radiotherapy from January 2011 to February 2012 were selected as the experimental group and 29 newly diagnosed NPC patients without radiotherapy as the control group. The cervical artery injury was observed by color Doppler ultrasound, blood glucose, blood lipid and magnetic resonance imaging (MRI) were performed. The data of hypertension, smoking, cardio-cerebral vascular events and other factors were collected. Results: there was no significant difference in the basic clinical data between the two groups. The incidence of carotid artery injury in the experimental group was 50% (44.25%), which was significantly higher than that in the control group (6 / 29 (20.69%) (P < 0.021). The common carotid artery injury was more common in the internal neck than that in the control group (P = 0.026, P = 0.046, respectively). Carotid stenosis 鈮

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