血管内支架成形术治疗高龄症状性椎动脉狭窄患者的临床研究

Clinical study of stent-assisted angioplasty in the treatment of elderly patients with symptomatic vertebral artery stenosis

目的探讨采用血管内支架成形术治疗高龄症状性椎动脉狭窄的临床疗效。方法将我院2013年1月~2014年12月收治的62例椎动脉狭窄患者随机分成观察组（31例）和对照组（31例）,观察组使用血管内支架成形术治疗方式,而对照组使用药物保守治疗方式。比较两组患者血流动力学指标改变情况、并发症情况、预后情况。结果观察组治疗后狭窄处峰值流速、阻力指数及患侧寰椎段阻力指数显著低于对照组,而患侧寰椎段峰值流速和血流量显著高于对照组（P〈0.05）。观察组显效率和总有效率均显著高于对照组,而并发症发生率显著低于对照组（P〈0.05）。结论血管内支架成形术是治疗老年症状性椎动脉狭窄的一种安全、有效的方法,近期疗效良好。

Objective To explore the clinical effect of stent-assisted angioplasty（SAA） in the treatment of elderly patients with symptomatic vertebral artery stenosis. Methods 62 patients with symptomatic vertebral artery stenosis treated in the hospital from January 2013 to December 2014 were randomly divided into observed group（31 cases） and control group（31 cases）.Patients in observed group were treated with endovascular stent angioplasty,while others received the treatment of medical therapy.The changes of hemodynamic parameters,complications and prognosis were compared between the two groups. Results After treatment, narrow peak flow velocity, resistance index（RI）and ipsilateral atlas resistance index of observed group was significantly lower than those of control group,while suffering from side atlas peak flow velocity and blood flow of observed group was significantly higher than those of the control group（P 0.05）.The cure rate and total effective rate of observed group were significantly higher than those of control group,but the complication rate of observed group were significantly lower than that of control group（P 0.05）. Conclusion SAA is a safe and effective strategy for the treatment of symptomatic vertebral artery stenosis in the elderly,the long outcome is favorable.