不同干预方式对症状性椎基底动脉缺血性脑卒中复发的影响

Effect of different interventions on the recurrence of symptomatic vertebrobasilar artery ischemic stroke

目的 观察不同干预方式对症状性椎基底动脉缺血性脑卒中(IS)复发的影响。方法对188例椎-基底动脉IS患者出院后随访12~30个月。依据不同的干预方式,将患者分为三组。A组63例,仅住院期间行药物治疗;B组69例,住院期间行药物治疗,出院后坚持二级预防治疗;C组56例,住院期间行支架治疗和药物治疗,出院后坚持二级预防治疗。比较三组IS复发情况。结果 随访期间共出现IS复发66例(35.11%)。A组IS复发率高于B组和C组(69.84%vs.20.29%和14.29%)(P<0.05)。A组多支血管病变IS复发率高于B组和C组(46.03%vs.10.14%和14.29%)(P<0.05)。A组和B组单支血管病变IS复发率高于C组(23.81%和10.14%vs.0%)(P<0.05)。结论 进行规范化药物和支架治疗能明显降低椎基底动脉IS的复发率。椎基底动脉单支血管病变支架治疗患者的IS复发率较低。

Objective To observe the effect of different interventions on the recurrence of symptomatic vertebrobasilar artery ischemic stroke(IS).Methods A total of 188 patients with vertebrobasilar artery IS were followed up for 12-30 months after discharge.On the basis of intervention method, the patients were divided into three groups.Medication during hospitalization was performed in group A(63 cases).Medication during hospitalization and the secondary preventive treatment after discharge were performed in group B(69 cases).Stent therapy and medication during hospitalization and the secondary preventive treatment after discharge were performed in group C(56 cases).The IS recurrence rate was compared among three groups.Results Of 188 patients, 66 cases(35.11%) had IS recurrence.The IS recurrence rate of group A was higher than that in groups of B and C(69.84% vs.20.29% and 14.29%)(P<0.05).The IS recurrence rate of the patients with multivessel lesion in group A was higher than that in groups of B and C(46.03% vs.10.14% and 14.29%)(P<0.05).The IS recurrence rate of the patients with single vessel lesion in groups of A and B was higher than that in group C(23.81% and 10.14% vs.0%)(P<0.05).ConclusionStandardized medication and stent treatment can significantly reduce recurrence rate of vertebrobasilar artery IS.The recurrence rate of IS is lower in the patients with single vascular lesion and stent treatment of the vertebrobasilar artery.