【摘要】 目的探讨全脑血管造影在指导脑梗死二级预防中的应用价值。方法纳入240例首次发病的动脉粥样硬化性脑梗死患者,分为造影组124例及对照组116例。对照组根据指南给予常规二级预防处理,造影组接受全脑血管造影检查,评估血管病变,采取个体化的二级预防措施。随访观察2年,比较造影组及对照组脑梗死复发率,并分析其安全性。结果 (1)造影组及对照组在性别、年龄构成及ESRS分值、NIHSS分值方面差异无统计学意义(P>0.05);(2)对照组治疗情况:阿司匹林+常规他汀85例,占73.28%,氯吡格雷+强化他汀31例,占26.72%;造影组治疗情况:阿司匹林+常规他汀59例,占47.58%,氯吡格雷+强化他汀38例,占30.66%,给予双抗+强化他汀治疗27例,占21.76%,颈动脉支架植入4例,椎动脉支架植入2例;(3)随访2年对照组有26例复发(复发率22.41%),造影组有15例复发(复发率12.10%)(P<0.05)。结论全脑血管造影检查能准确地评估患者脑血管病变情况,能给患者提供个体化的二级预防措施,有效地降低脑梗死复发率。更多还原

【Abstract】 Objective To investigate the application value of aortocranial angiography in the secondary prevention of cerebral infarction. Methods Take 240 cases of first-episode atherosclerosis cerebral infarction patients,and divided them into 124 cases of radiography group and 116 cases of control group. Apply general secondary prevention treatment to the control group according to the guideline,while individualized secondary prevention treatment to the control group by taking the aortocranial angiography examination and evaluating the vascular lesions. To follow-up for 2 year and compare the relapse rate of cerebral infarction for both radiography group and control group and analyze its safety. Results( 1) There is no statistical differences in the constitution of sex and age,ESRS grade and NIHSS grade( P > 0. 05).( 2) The treatment condition of control group is: 85 cases of aspirin + conventional statin,with a proportion of 73. 28%,and 31 cases of clopidogrel + strengthened statin,with a proportion of 26. 72%;while the condition of radiography group is: 59 cases of aspirin + conventional statin,with a proportion of 47. 58%,38 cases of clopidogrel + strengthened statin,with a proportion of 30. 66%,27 cases of dual antiplatelet +strengthened statin,with a proportion of 21. 76%,4 cases of treatment by implanting carotid stent and 2 cases of implanting carotid artery stending. Through 2 year of follow-up observation,thee are 26 cases of relapse( 22. 41%) in the control group,and 15( 12. 10%) in the radiography group( P < 0. 05). Conclusion The aortocranial angiography examination accurate assess the lesion of blood vessel of brain for the patients,will provide patients with an individualized secondary prevention solution,which can effectively reduce the relapse rate of cerebral infarction.更多还原