摘要
目的:探讨磁共振磁敏感加权成像(SWI)指导下个体化抗血小板方案治疗脑小血管疾病的有效性、安全性。方法:共纳入2019年1月—2020年4月南京鼓楼医院集团仪征医院收治的100例疑似脑小血管疾病患者作为研究对象。所有患者均接受磁共振SWI检查,选择符合颅内微出血病灶≥5个的脑小血管病患者入组(65例),以随机数表法将其分为对照组(32例,接受基础治疗,不给予抗血小板治疗药物)和观察组(33例,给予基础治疗结合双嘧达莫治疗),比较两组治疗前后不同时期的脑白质病变情况(Fazekas量表)、认知功能、日常生活能力以及不良事件发生情况。结果:治疗前,两组患者的Fazekas评分、认知功能评分、日常生活能力评分比较,差异无统计学意义(P>0.05)。治疗6个月后、1年后,观察组Fazekas评分较对照组更低,认知功能评分、日常生活能力评分较对照组更高(P<0.05)。两组颅内出血、消化道出血、剧烈头痛、肝功能异常等不良事件的发生率比较,差异无统计学意义(P>0.05)。结论:针对磁共振SWI颅内微出血病灶≥5个的脑小血管病患者,采用双嘧达莫抗血小板方案治疗可改善脑白质病变程度,延缓认知功能以及日常生活能力的下降,临床应用价值显著。
Objective To explore the effectiveness and safety of individualized antiplatelet regimens in the treatment of cerebral small vessel diseases under the guidance of magnetic resonance susceptibility weighted imaging(SWI).Methods From January 2019 to April 2020,100 patients with suspected cerebral small vascular disease were included as the research objects.All patients underwent magnetic resonance SWI examination.Patients with intracranial microhemorrhage lesions≥5 cerebrovascular diseases were selected into the group(65 cases),and in a random number table,they were divided into the reference group(32 cases,receiving basic treatment,not using any antiplatelet therapy drugs)and the treatment group(33 cases,basic treatment combined with dipyridamole treatment).The white matter lesions(Fazekas score),cognitive function,ability of daily living and dysfunction of the two groups at different periods before and after treatment were compared.Results Before treatment,the Fazekas scores,cognitive function scores,and daily living ability scores of the two groups were similar(P>0.05).After 6 months and 1 year of treatment,the Fazekas score of the treatment group was lower than that of the reference group,and the cognitive function score and the ability of daily living ability score were higher(P<0.05).There was no significant difference in the incidence of adverse events such as intracranial hemorrhage,gastrointestinal hemorrhage,severe headache,and abnormal liver function between the two groups(P>0.05).Conclusion In patients with cerebral small vessel disease with≥5 intracranial microhemorrhage lesions on MRI SWI,the use of dipyridamole antiplatelet regimen can improve the degree of white matter lesions,delay the decline of cognitive function and daily living ability,and its clinical application value significantly.
作者
徐大兴
李艳杰
李森
卢正娟
李新慧
秦正良
XU Daxing;LI Yanjie;LI Sen;LU Zhengjuan;LI Xinhui;QIN Zhengliang(Department of Neurology,Yizheng Hospital,Nanjing Drum Tower Hospital Group,Yangzhou,Jiangsu 211900,China)
出处
《影像研究与医学应用》
2022年第15期22-24,共3页
Journal of Imaging Research and Medical Applications
关键词
脑小血管疾病
磁共振磁敏感加权成像
抗血小板治疗
双嘧达莫
脑白质病变
Cerebral small vessel disease
Magnetic resonance susceptibility weighted imaging
Antiplatelet therapy
Dipyridamole
White matter lesions
