药物治疗与血管内支架治疗对症状性脑主要供血动脉狭窄患者临床疗效分析

Analysis the clinical effect of drug and endovascular stents in treatment of patients with symptomatic brain artery stenosis

目的探讨药物治疗与血管内支架治疗对症状性脑主要供血动脉狭窄患者临床疗效。方法分析本院2011年1月-2015年1月收治的121例症状性脑主要供血动脉狭窄患者临床资料,将采用内科药物治疗的39例患者为药物组;采用血管内支架治疗35例患者为手术组;采用内科药物联合血管内支架治疗47例患者记为联合组。对比三组患者治疗6个月和12个月后临床疗效以及治疗前和12个月后NIHSS评分和ADL评分,并记录随访期间不良脑血管事件发生率和病死率。结果三组患者6个月后和12个月后治疗成功率存在显著差异(均P<0.05),各组内比较差异无统计学意义(均P>0.05);6个月后和12个月后三组间和每两组间颈内动脉狭窄率、大脑中动脉狭窄率和基底动脉狭窄率比较均P<0.05,其中药物组最高、手术组次之、联合组最低;治疗前药物组、手术组和联合组NIHSS和ADL三样本间比较及两两比较均P>0.05,12个月后各组内NIHSS评分均较治疗前显著降低均P<0.05,ADL评分均较治疗前显著升高(均P<0.05),12个月后三组间NIHSS和ADL比较差异有统计学意义(均P<0.05);三组不良脑血管事件发生率和病死率比较差异无统计学意义(均P>0.05)。结论采用内科药物联合血管内支架治疗可以显著降低血管狭窄率,改善临床疗效,减少不良脑血管事件和死亡,改善神经功能缺损和生活自理能力。

Objective To analysis clinical efficacy of drug and endovascular stent treatment patients withsymptomatic brain artery stenosis.Method There were121patients with symptomatic brain artery stenosis werebeing choose and their clinical information were analyzed with retrospectively,39patients were treatmented withinternal medicine being as drug group and35patients were treatmented with endovascular stents being as operatedgroup;47patients were treatmented with internal medicine and endovascular stent being as combined group.Comparedclinical effect of three groups6months and12months after treatment and treatment before and after12months NIHSSscores and ADL scores,and recorded adverse cerebrovascular events incidence and mortality during the followupperiod.Results The success of treatment with three groups after6and12months were significant difference(P<0.05),within group was no significant difference(P>0.05);The middle cerebral artery stenosis rate and basalartery stenosis rate were significant difference(P<0.05)in three groups or between each two groups after6months and12months,which the highest drug group,the lowest scores times,the combined group;Before drug treatment group,the combined group of NIHSS and ADL scores and compare and comparing two differences between the three sampleshad no statistical significance(P>0.05),and12months after the NIHSS score within our group were significantlylower than before treatment(P<0.05)and ADL scores were significantly increased than before treatment(P<0.05),after12months of NIHSS and ADL compared differences between three groups was statistically significant(P<0.05);Three groups of adverse cerebrovascular events incidence and case fatality rate comparison difference has no statistical significance(P>0.05).Conclusion Internal medicine with endovascular stent therapy can Significantly reducedvascular stenosis rate,improve the clinical curative effect,reduce adverse cardiovascular events and death and improvenerve function defect and life self-care ability.