椎动脉起始部狭窄患者支架置入与单纯药物治疗疗效及安全性探讨

To investigate the efficacy and safety of stenting and drug therapy alone in treating patients with vertebral artery stenosis

目的:探讨分析椎动脉起始部狭窄患者支架置入联合药物治疗与单纯药物治疗的临床疗效及安全性差异。方法:回顾性分析2012年2月—2014年6月椎动脉起始部中重度狭窄患者74例,根据其选择的治疗方式分为支架组38例和药物组36例。支架组采取支架置入和药物治疗,药物组采用单纯药物治疗。比较两组患者一般情况、临床治疗效果及安全性方面的差异。结果:两组患者年龄、性别、脑血管病危险因素等一般情况比较,P>0.05,差异无统计学意义;支架组患者术后平均残余血管狭窄率为(7.3±3.8)%,术后NIHSS评分(2.3±0.9)分,随访1年发生缺血事件6例(15.8%),再狭窄6例(15.8%)。药物组术后平均残余血管狭窄率(53.2±10.1)%,术后NIHSS评分(3.7±1.1)分,随访1年发生缺血事件14例(38.9%),再狭窄13例(36.1%)。两组比较,P<0.05,差异有统计学意义。结论:支架置入配合药物治疗椎动脉起始部狭窄患者临床疗效较好,安全性较高。

Objective： To investigate the efficacy and safety of stenting combine with drug and drug therapy alone in treating patients with vertebral artery stenosis. Methods： A retrospective analysis of 74 patients with moderate to severe vertebral artery beginning part stenosis from February 2012 to June 2014,according to their treatment,divided into the stent group and the drug group,38 stent group patients taken stents and drug treatment,36 drug group cases treated with drug therapy alone,compared the difference between the two groups patients in general,clinical efficacy and safety. Result： There were no statistically significant differences in the age,sex,and other risk factors for cerebrovascular such general aspects of two groups patients（ P〈0. 05）; the average postoperative residual stenosis of stent group patients was（ 7. 3 ± 3. 8） %,national Institute of Health stroke scale（ NIHSS） score after surgery being（ 2. 3 ± 0. 9）,followed up six cases of ischemic events a year（ 15. 8%）,6 cases restenosis（ 15. 8%） compared with the drug group with the mean residual stenosis rate being（ 53. 2 ± 10. 1） %,NIHSS score after surgery being（ 3. 7 ± 1. 1）,1- year follow- up of 14 cases of ischemic events（ 38. 9%）,restenosis 13 cases（ 36. 1%）with a significant difference（ P〈0. 05）. Conclusion： Stenting with drug in treating patients with vertebral artery stenosis has amore satisfactory clinical efficacy,while with higher security,worthy of clinical application.