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1、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023-68757842,E-mail:lijingchengll@yahoo.com.cn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
2、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
3、架；血管成形术；内科治疗TheinfluenceofthestentingplacementandmedicaltreatmentontheprognosisofpatientswithsymptomaticmiddlecerebralarterystenosisWANGJian-hong，YANGQing-wu，LIJing-cheng，ZHANGLi-li，GAOChang-yue,FANGChuan-qin,ZHOUYu,WANGJing-zhou(DepartmentofNeurology
4、，InstituteofSurgeryResearch，DapingHospital，ThirdMilitaryMedicalUniversity，Chongqing400042，China)Abstract:ObjectiveThisstudyreportsatrailtoinvestigatetheeffectivenessbetweenthestentingplacementandmedicaltreatmentonpatientswithsymptomaticmiddlecerebrala
5、rtery(MCA)stenosis.Methods56patientswhometselectioncriterionweredividedintostentingplacementgroupincluding21patientsandmedicaltreatmentgroupincluding35patients.Inthestentingplacementgroupweretreatedwithstent,medicaltreatmentgroupweretreatedwithdrugs;t
6、wogroupswereobservedandfollowedup1yearefficacy,theincidenceofcerebrovasculareventsobserved.ResultsStentgroup,21casesofsuccessfulstenting,2ofcerebralhemorrhage,1patientdied,1patientsicker.4instentingplacementgroupoccurredslightstrokelocatedinblood-supp
7、lyareaoforiginalstenoticarteryand7inmedicaltreatmentgrouphappenedstrokeagain（P＜0.01）.ConclusionsStentasssistedangioplastyisasafe,feasibletherapyformiddlecerebralarterystenosis,thebetterbenefitcomefromstrictlycontrolofcomplications.However,comparedwith
8、drugtreatmentalone,whichdoesnotsignificantlyimproveafter1yearevent-freesurvival.Keywords:middlecerebralstenosis;Stent;Angioplasty;Medicaltherapy颅内大动脉粥样硬化性狭窄是缺血性脑卒中的常见原因[1]。大规模人群的调查显示台湾和中国大陆颅内大血管狭窄多于颅外大血管狭窄[2,3]。颅内动脉狭窄病变的单纯药物治疗包括寻找和去除危险因子及联合使用抗
