支架成形术及药物治疗症状陛大脑中动脉狭窄的随机对照.pdf

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1、介入放射学杂志2013年2月第22卷第2期JInterventRadiol2013，Vo1．22，No．2——89——·神经介入Neurointervention·支架成形术及药物治疗症状陛大脑中动脉狭窄的随机对照研究高红华．高连波【摘要】目的比较单纯药物治疗及药物联合支架治疗症状性大脑中动脉重度狭窄的疗效。方法采用单中心、随机、对照、前瞻性研究，将34例症状性大脑中动脉狭窄≥70％的患者随机分为药物治疗组(药物组)18例和药物联合支架治疗组(支架组)16例，并进行12个月以上的随访，终点事件为狭窄动脉供血区出现脑卒中。结果支架组与药物组均无出血性脑卒中发生

2、。随访期内，药物组18例中发生狭窄侧大脑中动脉供血区再发脑梗死5例(27．78％)，3例发生大脑中动脉闭塞(16．67％，其中2例为无症状性闭塞)，支架组未发生支架侧脑梗死，12个月时复查DSA无支架内再狭窄或闭塞。支架组缺血性脑卒中复发率低于药物组(P<0．05)。结论选择性的支架治疗对预防缺血性脑卒中的复发可能较单纯药物治疗更为有效。【关键词】缺血性脑卒中；大脑中动脉；支架中图分类号：R743．3文献标志码：A文章编号：1008—794X(2013)一02．0089—04Stentimplantationcombinedwithdrugtherapyve

3、rsuspuredrugtherapyforsymptomaticseverestenosisofmiddlecerebralartery：arandomizedandcomparativestudyGA0Hong—hua．GA0Lian-bo．DepartmentofNeurology，theFourthAfiliatedHospital，ChinaMedicalUniversity，Shenyaug110032，ChinaCorrespondingauthor：GA0Lian—bo，E—mail：0710@sincacom一【Abstract】Objec

4、tiveTocomparetheclinicaleficacyofstentimplantationcombinedwithdrugtherapyandpuredrugtherapyintreatingsymptomaticseverestenosisofmiddlecerebralartery．MethodsAsasingle—center，randomized，comparativeandprospectivestudy，atotalof34patientswithsymptomaticseverestenosisofmiddlecerebralarte

5、ry(≥70％)werecollected．Thepatientswererandomlydividedintopuredrugtherapygroup(n=18)andstentgroup(stentimplantationtogetherwithdrugtherapy，n：16)．Allthepatientswerefollowedupforatleast12months．Theend—pointeventwastheoccurrenceofcerebralstrokeatthecerebralregionthatwassuppliedbythenarr

6、owedartery．Theclinicalresultswereanalyzedandwerecomparedbetweenthetwogroups．ResultsNohemorrhagicstrokeoccuredinbothgroups．Duringthefollow—upperod，inthepuredrugtherapygrouprecurentcerebralinfarctionattheareathatwassuppliedbymiddlecerebralarteryatthediseasedsideoccuredinfivecases(27．

7、78％)，andtheocclusionofmiddlecerebralarterywasseeninthreecases(16．67％)，twoofwhomshowednoclinicalsymptomsofcerebralarteryocclusion．Nocerebralinfarctionoccurredinthestentgroup．DSAperformed12monthsafterthetreatmentshowednoin-stentstenosisorocclusion．ConclusionSelectivestentimplantation

8、therapyisprobablymoreeffec