颅内动脉狭窄的支架成形术与内科治疗的疗效观察

Therapeutic effects between the stent asssisted angioplasty and medical treatment on patients with intracranial artery stenosis

目的比较血管内支架成形术与内科药物治疗对颅内动脉狭窄的疗效。方法符合入选标准的96例颅内动脉狭窄患者根据其经济承受能力及自愿原则,分为支架成形术(SAA)组30例和内科药物治疗组66例。每半年临床随访一次,随访时间6-36个月,平均18．9个月。详细记录(1) 随访期间的卒中复发率及病死率;(2)MMSE评分;(3)mRS(modified rankin scale)评分,以mRS 2分以下为生存质量高,3分以上为生存质量差。结果 SAA组有2例(6．7％)发生原狭窄动脉供血区的轻微卒中,内科治疗组10例(15．2％)再发卒中(P<0．01);MMSE评分提示SAA组患者的认知功能改善优于内科治疗组(P<0．05);两组mRS评分比较提示SAA组患者的生存质量优于内科治疗组。结论血管内支架成形术治疗颅内动脉粥样硬化性狭窄是安全的、可行的,其疗效优于内科保守治疗。

Objective To compare the effectiveness between the stent asssisted angioplasty （SAA） and medical treatment on patients with intracranial artery stenosis. Methods According to economic status and voluntary principle, 96 patient who met selection criterion were divided into SAA group including 33 patients and medication group including 66 patients. Follow-up was given to those patients once every half a year and follow-up period lasted six to thirty-six months, average 18.9 months. Medical records collected included： 1. Recurrence and morbidity during the period of follow-ups; 2. MMSE scale; 3. Modified rankin scale（ mRS）, ≤2 point indicating a higher quality of life and ≥3 point indicating a poor quality of life. Results 2 in SAA group occurred slight stroke located in blood-supply area of original stenotic artery and 10 in medication group happened stroke again （P 〈0.01 ）. Significant differences were shown between the two groups in MMSE （ P 〈 0.05 ）. A comparison to mRS between two groups showed quality of life of SAA group was better than that of medication group. Conclusions SAA is a safe, feasible therapy for intracranial artery stenosis, which has a significant advantage over medical therapy.