药物及介入治疗对症状性大脑中动脉狭窄患者预后的影响.docVIP

药物及介入治疗对症状性大脑中动脉狭窄患者预后的影响 王建红 杨清武 李敬诚 张莉莉 高长越 方传勤 周瑜 王景周(400020重庆 第三军医大学大坪医院神经内科一) [通讯作者]：李敬诚 023E-mail:lijingchengll@ 摘要：目的 探讨症状性大脑中动脉狭窄患者药物及介入治疗对疾病转归和预后的影响。方法　将符合入选标准的56例症状性大脑中动脉狭窄患者按治疗方法不同分为两组, 支架介入治疗组(n=21)和药物治疗组(n=35)，支架介入治疗组进行大脑中动脉狭窄支架置入治疗，药物组单纯应用药物治疗；两组病例观察疗效并随访1年,观察脑血管事件发生率。结果　21例支架介入治疗组患者均成功置入支架,但2例发生脑出血，1例死亡，1例病情加重。术后随访19例支架介入治疗组有4例（21.1%）发生原狭窄动脉供血区的轻微卒中,35例单纯药物治疗组患者7例（20%）再发卒中，两组差异无统计学意义（P＜0.01）。结论　支架介入治疗症状性大脑中动脉狭窄患者安全、有效,严格控制并发症能让患者获益，但与单用药物治疗相比,其并不能显著改善1年后的无事件生存率。 关键词：大脑中动脉狭窄；支架；血管成形术；内科治疗 The influence of the stenting placement and medical treatment on the prognosis of patients with symptomatic middle cerebral artery stenosis WANG Jian-hong，YANG Qing-wu，LI Jing-cheng，ZHANG Li-li，GAO Chang-yue , FANG Chuan-qin,ZHOU Yu,WANG Jing-zhou (Department of Neurology，Institute of Surgery Research，Daping Hospital，Third Military Medical University，Chongqing 400042，China) Abstract: Objective This study reports a trail to investigate the effectiveness between the stenting placement and medical treatment on patients with symptomatic middle cerebral artery (MCA) stenosis. Methods 56 patients who met selection criterion were divided into stenting placement group including 21 patients and medical treatment group including 35 patients. In the stenting placement group were treated with stent, medical treatment group were treated with drugs; two groups were observed and followed up 1 year efficacy, the incidence of cerebrovascular events observed.Results Stent group, 21 cases of successful stenting, 2 of cerebral hemorrhage, 1 patient died, 1 patient sicker.4 in stenting placement group occurred slight stroke located in blood-supply area of original stenotic artery and 7 in medical treatment group happened stroke again （P＜0.01 ）. Conclusions Stent asssisted angioplasty is a safe,feasible therapy for middle cerebral artery stenosis,the better benefit come from strictly control of complications.However, compared with drug treatment alone, which does