摘要
目的对比观察脑血管支架植入术与药物治疗青年脑梗死合并大脑中动脉狭窄的效果。方法71例(30~44岁)脑梗死合并大脑中动脉重度狭窄(狭窄率>70%)患者,分别接受常规口服药物治疗(药物组,n=39)和支架植入术(支架组,n=32),比较2组相关指标。结果支架组手术成功率100%,共植入32枚支架。2组患者入组时及随访3、6、12、24个月,改良Rankin量表(mRS)评分、美国国立卫生研究院卒中量表(NIHSS)评分组内比较差异均有统计学意义(P均<0.01),mRS、NIHSS评分组间比较差异均无统计学意义(P均>0.05)。随访期间药物组终点事件发生率、卒中再发率及再发卒中致残率(mRS评分≥2分)分别为20.51%(8/39)、20.51%(8/39)及20.51%(8/39),支架组分别为6.25%(2/32)、3.13%(1/32)及3.13%(1/32),2组间终点事件发生率差异无统计学意义(P=0.17),支架组卒中复发率(P=0.04)及再发卒中致残率(P=0.04)均低于药物组。结论相比药物治疗,植入支架可降低青年脑梗死合并大脑中动脉狭窄患者卒中复发率及致残率。
Objective To compare the effect of stent implantation and drug treatment for young cerebral infarction combined with middle cerebral artery stenosis.Methods A total of 71 young cerebral infarction patients(aged 30-44 years)with severe stenosis of middle cerebral artery(stenosis rate>70%)were enrolled and divided into drug group(n=39,received conventional oral medication)and stent group(n=32,underwent stent implantation).The therapeutic effects and follow-up outcomes during 24 months were compared between 2 groups.Results The success rate of stent group was 100%,and 32 stents were implanted.Significant differences were found between the scores at enrollment and those at 3,6,12 and 24 months of modified Rankin scale(mRS)and National Institutes of Health Stroke Scale(NIHSS)within both the two groups during the follow-up(all P<0.05),while there was no statistically significant difference of mRS nor NIHSS scores at any comparison between 2 groups(all P>0.05).Within 24 months'follow-up,the incidence of end-point event was 20.51%(8/39),the stroke recurrence rate was 20.51%(8/39),and the disability rate of recurrence stroke(mRS score≥2 points)was 20.51%(8/39)in drug group,while in stent group was 6.25%(2/32),3.13%(1/32)and 3.13%(1/32),respectively.There was no statistically significant difference of the incidence of endpoint events between 2 groups(P=0.17),while the recurrence rate of stroke(P=0.04)and the disability rate of recurrent stroke(P=0.04)in stent group were both lower than those in drug group.Conclusion Compared with drug therapy,stent implantation can reduce stroke recurrence rate and disability rate of in young cerebral infarction with middle cerebral artery stenosis.
作者
苏旭东
姚冬静
刘增品
周存河
王聪
连云成
于江华
SU Xudong;YAO Dongjing;LIU Zengpin;ZHOU Cunhe;WANG Cong;LIAN Yuncheng;YU Jianghua(Department of Neurology,the Second Hospital of Hebei Medical University,Hebei Key Laboratory of Neurology,Shijiazhuang 050000,China;Department of Pediatrics,Hebei General Hospital,Shijiazhuang 050000,China;Department of Neurology,Fucheng County People's Hospital,Fucheng 053799,China)
出处
《中国介入影像与治疗学》
北大核心
2020年第10期590-594,共5页
Chinese Journal of Interventional Imaging and Therapy
基金
河北省医学科学研究重点课题(20160553)。
关键词
脑梗死
大脑中动脉
支架
化学
药物
cerebral infarction
middle cerebral artery
stents
chemistry,pharmaceutical
