【摘要】 目的分析前循环症状性颅内动脉狭窄患者血管内支架植入联合药物治疗的有效性和安全性。方法选取2012年4月—2016年4月广西壮族自治区人民医院神经内科/广西脑卒中中心收治的前循环症状性颅内动脉狭窄患者108例作为研究对象,根据治疗方法分为颅内动脉支架成形术联合药物治疗组(观察组)51例,单纯药物治疗组(对照组)57例,比较2组患者治疗后1、6、12个月神经功能预后(NIHSS评分、改良Rankin评分),观察记录终点事件(卒中复发、死亡)发生率。结果治疗组患者术后6个月及12个月时NIHSS评分均低于对照组(t=-3.903,P<0.001;t=-3.006,P=0.003),术后12个月时改良Rankin评分均低于对照组(t=-2.091,P=0.039);2组患者术后6个月和12个月终点事件发生率差异均无统计学意义(术后6个月:7.84%vs. 10.53%,χ~2=0.231,P=0.746;术后12个月:11.76%vs. 14.04%,χ~2=0.455,P=0.565)。2组患者生存率比较差异亦无统计学意义(P>0.05)。结论对于前循环症状性颅内动脉狭窄患者,支架成形术联合药物治疗效果和安全性优于单纯药物治疗。更多还原

【Abstract】 Objective To analyze the efficacy and safety of intravascular stent implantation combined with drug therapy in patients with symptomatic anterior circulation intracranial artery stenosis. Methods One hundred and eight patients with symptomatic anterior circulation intracranial artery stenosis admitted to the Neurological Department of Guangxi People’s Hospital from April 2012 to April 2016 were selected as the study subjects. According to the treatment methods, 51 patients were divided into the intracranial artery stenting combined with drug therapy group(observation group) and 57 patients in the drug treatment group(control group). One month after treatment, the two groups were compared. Neurological prognosis(NIHSS score, modified Rankin score) at 1, 6 and 12 months and the incidence of end-point events(stroke recurrence and death) were observed and recorded.Results The NIHSS scores of patients in the treatment group were lower than those in the control group at 6 months and 12 months after operation(t=-3.903,P<0.001; t=-3.006,P=0.003), and the modified Rankin scores at 12 months after operation were lower than those in the control group(t=-2.091,P=0.039). There was no significant difference in the incidence of end events between the two groups at 6 months and 12 months after operation(6 months after operation: 7.84% vs. 10.53%, χ~2=0.231,P=0.746; 12 months after operation: 11.76% vs. 14.04%, χ~2 =0.455,P=0.565). There was no significant difference in survival rate between the two groups(P>0.05). Conclusion For patients with symptomatic anterior circulation intracranial artery stenosis, stenting combined with drug therapy is more effective and safe than drug therapy alone.更多还原