Wingspan支架植入术对大脑中动脉重度狭窄患者神经功能缺损、事件相关电位P300及预后的影响

Effects of Wingspan Stent Implantation on Neurological Function Defect,Event Related Potential P300 and Prognosis in Patients with Severe Middle Cerebral Artery Stenosis

【目的】探讨Wingspan支架植入术对大脑中动脉重度狭窄患者神经功能缺损、事件相关电位P300及预后的影响。【方法】选取2018年5月至2020年5月两院收治的104例大脑中动脉重度狭窄患者,依据治疗方案不同将其分为观察组(n=53)和对照组(n=51)。对照组采用规范化药物治疗,观察组在对照组基础上采取Wingspan支架植入术。比较两组临床疗效、预后不良事件发生率、美国国立卫生院卒中量表(NIHSS)评分、简易精神状态评价量表(MMSE)评分、日常生活活动能力量表(BI)评分及大脑中动脉血流动力学指标[舒张期末流速(Vd)、收缩期峰流速(Vs)、平均血流速度(Vm)]、事件相关电位P300指标(波幅、潜伏期)水平。【结果】观察组临床总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后12个月,观察组NIHSS评分与大脑中动脉Vd、Vs、Vm水平低于对照组,MMSE、BI评分高于对照组(P<0.05);观察组事件相关电位P300波幅均高于对照组,潜伏期均低于对照组(P<0.05)。观察组预后不良事件发生率低于对照组,差异有统计学意义(P<0.05)。【结论】应用Wingspan支架植入术治疗大脑中动脉重度狭窄患者可减轻神经功能缺损程度,改善大脑中动脉血流动力学、事件相关电位P300相关指标,有助改善患者认知功能、日常生活能力。

【Objective】To analyze the effects of Wingspan stent implantation on neurological deficits,event-related potentials P300 and prognosis in patients with severe middle cerebral artery stenosis.【Methods】A total of 104 patients with severe stenosis of middle cerebral artery admitted to the Hospital of Northwestern Polytechnical University from May 2018 to May 2020 were selected and divided into the observation group(n=53)and the control group(n=51)according to different treatment schemes.The control group was treated with standardized drugs,and the observation group was treated with Wingspan stent implantation on the basis of the control group.The clinical efficacy,incidence of adverse events,NIHSS score,MMSE score,activity of daily living(BI)score and middle cerebral artery hemodynamics index[End diastolic velocity(Vd),peak systolic velocity(Vs),average blood flow velocity(Vm)],P300 index(amplitude and latency)level of event related potential were compared between the two groups.【Results】The total clinical effective rate of the observation group was higher than that of the control group,with a statistically significant difference(P<0.05).12 months after treatment,NIHSS score and Vd,Vs,Vm levels of middle cerebral artery in the observation group were lower than those in the control group,while MMSE,BI scores were higher than those in the control group(P<0.05);The amplitude of event related potential P300 in the observation group was higher than that in the control group,and the latency was lower than that in the control group(P<0.05).The incidence of adverse events in the observation group was lower than that in the control group(P<0.05).【Conclusion】Conclusion Wingspan stent implantation in the treatment of severe stenosis of middle cerebral artery can reduce the degree of neurological deficit,improve the hemodynamics of middle cerebral artery and the related indexes of event related potential P300,and help improve the cognitive function and daily living ability of patients.