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目的比较药物治疗与血管内支架治疗症状性脑供血动脉狭窄的临床疗效。方法选取2011年1月—2015年1月鄂尔多斯市准格尔旗中心医院收治的症状性脑供血动脉狭窄患者74例,根据治疗方法分为药物组39例和手术组35例。药物组患者采用药物治疗,手术组患者行血管内支架治疗。比较两组患者治疗6、12个月后治疗成功率、颈内动脉狭窄率、大脑中动脉狭窄率、基底动脉狭窄率,治疗前和治疗12个月后美国国立卫生研究院卒中量表(NIHSS)评分和日常生活活动能力量表(ADL)评分,治疗后12个月内不良脑血管事件发生率和病死率。结果治疗6、12个月后,手术组患者治疗成功率高于药物组,颈内动脉狭窄率、大脑中动脉狭窄率、基底动脉狭窄率低于药物组(P<0.05)。治疗前两组患者NIHSS评分、ADL评分比较,差异无统计学意义(P>0.05);治疗12个月后手术组患者NIHSS评分低于药物组,ADL评分高于药物组(P<0.05)。两组患者治疗后12个月内短暂性脑缺血发作、脑梗死发生率及病死率比较,差异无统计学意义(P>0.05)。结论血管内支架治疗症状性脑供血动脉狭窄的临床疗效优于药物治疗。
Objective To compare the clinical effects of drug therapy and endovascular stenting on symptomatic cerebral artery stenosis. Methods From January 2011 to January 2015, 74 patients with symptomatic cerebral artery stenosis admitted in Zhunge’erqi Central Hospital of Erdos City were enrolled. According to the treatment methods, 39 patients were divided into drug group and 35 patients in operation group. The patients in the drug group were treated with drugs and the patients in the operation group were treated with endovascular stent. The treatment success rate, carotid artery stenosis rate, middle cerebral artery stenosis rate and basilar artery stenosis rate were compared between the two groups after treatment for 6 and 12 months. The National Institutes of Health Stroke Scale (NIHSS ) Score and activity of daily living scale (ADL) scores, incidence of adverse cerebrovascular events and mortality within 12 months after treatment. Results After 6 and 12 months of treatment, the success rate of the treatment group was higher than that of the drug group. The rate of stenosis of carotid artery, stenosis of middle cerebral artery and stenosis of basilar artery were lower than those of the drug group (P <0.05). There was no significant difference in NIHSS score and ADL score between the two groups before treatment (P> 0.05). After 12 months of treatment, NIHSS score of operation group was lower than that of drug group, and ADL score was higher than that of drug group (P <0.05). The two groups of patients within 12 months after treatment of transient ischemic attack, cerebral infarction and mortality rates, the difference was not statistically significant (P> 0.05). Conclusion The clinical efficacy of endovascular stenting in the treatment of symptomatic cerebral artery stenosis is better than that of drug treatment.