摘要
目的比较血管内治疗与药物治疗症状性颅内动脉粥样硬化性狭窄患者的结局以及血管再狭窄情况,为预防脑卒中复发及选择最佳治疗方案提供参考依据。方法选取2015年4月—2017年4月沧州市人民医院收治的症状性颅内动脉粥样硬化性狭窄患者69例为研究对象。采用高分辨率磁共振成像(HR-MRI)进行颅内动脉狭窄扫描,飞行时间磁共振血管成像(TOF-MRA)重建并确定血管结构和动脉狭窄位置。根据患者意愿,将其分为药物治疗组(37例)和血管内治疗组(32例),分别采用药物治疗或血管内支架植入。于术后1、2、3、6个月随访,记录脑卒中、短暂性脑缺血发作及再狭窄发生率。结果随访期间,两组均无死亡患者。随访1个月时,血管内治疗组无脑卒中、再狭窄发生,药物治疗组发生脑卒中、再狭窄各1例,差异无统计学意义(P=1.000、1.000)。随访6个月时,血管内治疗组脑卒中总发生率、再狭窄总发生率分别为0、12.5%(4/32),药物治疗组脑卒中总发生率、再狭窄总发生率分别为16.2%(6/37)、35.1%(13/37),差异有统计学意义(χ~2=5.683,P=0.017;χ~2=4.735,P=0.030)。结论症状性颅内动脉粥样硬化性狭窄患者血管内治疗6个月后脑卒中、再狭窄发生率低于药物治疗。
Objective To compare the vascular restenosis and treatment outcomes in patients with symptomatic intracranial atherosclerotic stenosis treated with either endovascular treatment or drug therapy,in order to provide a reference for preventing stroke recurrence and choosing optimal treatment plans.Methods A total of 69 patients with symptomatic intracranial atherosclerotic stenosis treated in the Cangzhou People's Hospital between April 2015 and April 2017 were selected as study subjects.HR-MRI scanning was used to detect intracranial arterial stenosis,and TOF-MRA was used to reconstruct vascular structure and determine the location of stenosis.The patients voluntarily chose to be enrolled in the drug therapy group(37 cases)or endovascular treatment group(32 cases),in which drug therapy or intravascular stent implantation,respectively,were administered.Follow-up visits were conducted 1,2,3,and 6 months after surgery.The incidences of stroke,transient ischemic attack,and restenosis were recorded.Results There were no deaths in both groups during the follow-up period.In the first month,there were no stroke and restenosis cases in the endovascular treatment group;while in the drug therapy group,there was one case each of stroke and restenosis,although the difference was not significant(P=1.000,1.000).After the six months,the incidences of stroke and restenosis in the endovascular treatment group were 0 and 12.5%(4/32),respectively,in contrast to 16.2%(6/37)and 35.1%(13/37)in the drug therapy group;the difference was statistically significant(χ2=5.683,P=0.017;χ2=4.735,P=0.030).Conclusion Compared with drug therapy,endovascular treatment was associated with a lower incidence of stroke and restenosis in patients with symptomatic intracranial atherosclerotic stenosis.
作者
刘义
杨丽华
王艳玲
马媛媛
LIU Yi;YANG Li-hua;WANG Yan-ling;MA Yuan-yuan(Department of Emergency Medicine,Cangzhou People's Hospital,Cangzhou 061000,China;Department of Neurology,Cangzhou People's Hospital,Cangzhou 061000,China)
出处
《中国全科医学》
CAS
北大核心
2018年第23期2867-2870,共4页
Chinese General Practice
基金
沧州市科技局课题(162302140)
关键词
卒中
颅内动脉硬化
支架
预后
Stroke
Intracranial arteriosclerosis
Stents
Prognosis
