探讨大脑中动脉支架成形术在症状性大脑中动脉重度狭窄治疗中的应用价值

Investigation on the application value of middle cerebral artery stenting in the treatment of symptomatic severe stenosis of middle cerebral artery

目的分析大脑中动脉(MCA)支架成形术在症状性MCA重度狭窄治疗中的应用价值。方法 68例症状性MCA重度狭窄患者,根据患者是否接受手术的意愿不同分为实验组(33例)和对照组(35例)。对照组患者给予药物治疗,实验组患者在药物治疗基础上给予MCA支架成形术治疗。随访1年,比较两组患者的不良事件发生情况及MCA狭窄段血流速度。结果实验组患者不良事件发生率为15.15%(5/33),明显低于对照组的42.86%(15/35),差异具有统计学意义(χ^2=6.28, P<0.05)。治疗前,两组患者MCA狭窄段收缩期峰值血流速度(PSV)、舒张末期血流速度(EDV)比较差异无统计学意义(P>0.05)。治疗1年后,实验组患者MCA狭窄段PSV、EDV低于对照组,差异具有统计学意义(P<0.05)。结论在药物治疗的基础上给予MCA支架成形术治疗症状性MCA重度狭窄患者疗效显著,有利于减少狭窄血管供血区缺血事件、血管狭窄等不良事件的发生,恢复狭窄段血流速度。

Objective To analyze the value of middle cerebral artery (MCA) stent angioplasty in the treatment of symptomatic severe stenosis of MCA. Methods A total of 68 patients with symptomatic severe stenosis of MCA were divided into experimental group (33 cases) and control group (35 cases) according to their willingness to undergo surgery. The control group was treated with drug therapy, and the experimental group were treated with MCA stent angioplasty on the basis of drug therapy. After 1 year of follow-up, the adverse events and the blood flow velocity of the MCA stenosis were compared between the two groups. Results The experimental group had obviously lower incidence of adverse events as 15.15%(5/33) than 42.86%(15/35) in the control group, and the difference was statistically significant (χ^2=6.28, P<0.05). Before treatment, both groups had no statistically significant difference in peak systolic velocity (PSV) and end diastolic velocity (EDV) in MCA stenosis (P>0.05). After 1 year of treatment, the experimental group had lower PSVand EDV in MCA stenosis than the control group, and the difference was statistically significant (P<0.05). Conclusion On the basis of drug therapy, MCA stent angioplasty is effective in the treatment of symptomatic severe stenosis of MCA. It is helpful to reduce the occurrence of ischemic events and vascular stenosis in the stenosis blood supply area and restore the blood flow velocity in the stenosis segment.