症状性脑动脉狭窄未行支架植入患者个体化血压调治技术研究  

Researching individualized modulation of blood pressure in symptomatic cerebral artery stenosis patients without stent implantation

作　　者：王连芹 魏玉清 张青川 孔咏梅 吉训明[2] 宁海春 李国锋 李英 殷海清 

机构地区：[1]河北省邢台市第三医院/邢台市脑血管病治疗中心神经内科,054000 [2]首都医科大学宣武医院神经内科,北京100053

出　　处：《疑难病杂志》2011年第12期897-900,共4页Chinese Journal of Difficult and Complicated Cases

基　　金：河北省科学技术研究与发展计划项目(No.10276105D-30)

摘　　要：目的探讨症状性脑动脉狭窄未行支架植入患者个体化血压调治技术的效果、终点事件及安全性。方法初发的症状性脑动脉狭窄患者1126例,随机分为治疗组787例,对照组339例。治疗组给予个体化血压调治技术,以8个层次最佳目标血压根据病情给予实施;对照组参照中国高血压防治指南对血压进行调控。比较2组治疗后3年和5年健康功能水平、终点事件、不良反应、依从性情况。结果治疗组治疗3年和5年后健康功能水平均高于对照组(P<0.05);治疗组3年和5年脑梗死发生和复发、心脏事件发生率均明显低于对照组(6.0%vs 13.3%、9.5%vs 19.2%、5.9%vs 12.4%,P<0.01)。治疗后5年病死率低于对照组(4.2%vs 7.4%,P<0.05)。2组出血性表现、心肾功能不全和高血压脑病发生率差异无统计学意义(P>0.05)。治疗组退出率低于对照组(5.3%vs13.6%,P<0.05)。结论症状性脑动脉狭窄未行支架植入患者个体化血压调治技术可显著降低脑梗死发生和复发、心脏事件和病死率,极大提高功能健康水平,效果显著,使用安全,患者依从性好。Objective To investigate the effect,end point event and security in symptomatic cerebral artery stenosis patients without stent implantation but conducted individualized modulation of blood pressure therapeutic schedule.Methods Totally 1126 cases who suffered from symptomatic cerebral artery stenosis first time onset,were randomly divided into treatment group（787 cases） and control group（339 cases）.The patients in treatment group were given individualized modulation of blood pressure,conducted in eight stratifications and best goal of blood pressure base on patient.The patients in control group were given modulation of blood pressure according to the China Guidelines for the prevention and treatment of hypertension. Comparing the health function,end point event,adverse reactions and compliance after three years,after three years and five years treatment in two groups.Results The treatment group in 3 and 5 years had higher healthy function than control group（P0.05）.In the treatment group,the 3 and 5 years incidence of cerebral infarction,recurrence and cardiac events were significantly lower than those in the control group（6.0%vs 13.3%,9.5%vs 19.2%,5.9%vs 12.4%,all P0.01）.In the treatment group,total mortality rale was significantly lower in 5 years after treatment than that in the control group（4.2%vs 7.4%,P（）.05）.The two groups had no statistical difference in incidence hemorrhagic manifestations,cardiac and renal function failure hypertensive encephalopathy（P0.05）.The withdraw rale in the treatment group was lower than that of in the control group（5.3%vs 13.6%,P0.05）.Conclusion The patients with symptomatic cerebral artery stenosis without stent implantation and conducted individualized modulation of blood pressure therapeutic schedule reduced the incidence of cerebral infarction and recurrence,cardiac events and mortality rate,the therapy greatly improves functional health with remarkable,secure effect and good compliance.

关 键 词：脑动脉狭窄 症状性 个体化血压调治 依从性 预后 

分 类 号：R743[医药卫生—神经病学与精神病学]