支架置入与单纯药物治疗孤立性眩晕合并椎动脉起始部狭窄患者的近期疗效观察

Recently observation on the efficacy of stent implantation and pure drug therapy in patients with isolated vertigo and vertebral artery stenosis

目的探讨临床中以孤立性眩晕为首发症状的椎动脉起始部狭窄患者血管内支架成形术与单纯药物治疗的近期疗效。方法连续收集2014年9月至2015年6月间共31例椎动脉起始部狭窄(狭窄率>50%)患者的临床资料,均以孤立性眩晕为首发症状,按治疗方法的不同分为血管内支架成形术(观察组)15例和单纯药物治疗(对照组)16例进行近期疗效观察。结果 31例患者至少随访3个月发现观察组眩晕再发较对照组明显减少,无缺血性事件发生。对照组有6例眩晕再发,其中2例小脑梗死,1例脑桥梗死,1例右侧枕叶梗死,2例复查头颅磁共振血管成像提示一侧椎动脉闭塞。结论在药物治疗的基础上行椎动脉起始部狭窄血管内支架成形术可以进一步降低孤立性眩晕合并椎动脉起始部狭窄患者眩晕再发,能较好地预防缺血性脑卒中发生率。

Objective To investigate the short term efficacy of sent implantation from cutaneous artery and pure drug therapy in patients, who suffered the vertebral artery stenosis with isolated vertigo as the first clinical symptom. Methods Collected the clinical data of 31 patients with medium and severe vertebral arte,＇y stenosis （stenosis ratio 〉 50 %） from September 2014 to June 2015, and all the patients had the vertebral artery stenosis with isolated vertigo as the first clinical symptom. According to the different therapeutic methods, the patients were divided into two groups, 15 patients underwent endovascular stent angioplasty （experimental group） while the other 16 patients underwent pure drug therapy （comparison group）. Results After random observation among the 31 patients within 3 months, it was founded that the vertigo recurrence in experimental group reduced remarkably and had no blood acci- dents appeared. Comparatively, there were 6 cases with vertigo reoccurrence in comparison group including 2 with cerebellar infarctions, 1 with pontine infarction, 1 with right occipital lobe infarction, 2 with unilateral vertebral artery occlusions after MRA reexamination. Conclusion The additional stent angioplasty based on the drug therapy could further reduce the vertigo recurrence in patients with isolated vertigo and vertebral artery stenosis, and positively pre- vent the incidence rate of Ischemic stroke.