椎动脉开口狭窄介入治疗后血流动力学状态的变化及对脑卒中患病率的影响  

Study on the influence of interventional therapy for treatment of vertebral artery ostial stenosis on hemodynamic changes and prevalence of stroke

作　　者：袁景林[1] 

机构地区：[1]北京市大兴区人民医院神经内科,北京102600

出　　处：《临床和实验医学杂志》2016年第14期1411-1414,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨椎动脉开口狭窄介入治疗后血流动力学状态的变化及对脑卒中患病率的影响。方法对2010年3月至2013年3月收治的椎动脉开口狭窄患者52例的临床资料进行统计分析,对支架置入情况和围手术期并发症发生情况、手术前后经颅多普勒超声血流动力学指标、临床疗效和远期并发症发生情况进行观察。结果 52例患者术后数字减影脑血管造影即刻残余狭窄率（9.0±2.9）%显著低于术前狭窄率（80.8±5.2）%（P〈0.05）。手术成功率为100%,围手术期并发症发生率为0;手术后2~7 d、1个月患者的狭窄处椎动脉峰值流速（PSV）、阻力指数（RI）均显著低于手术前（P〈0.05）;患侧寰椎段时间平均流速（TAV）、RI、血流量（FV）均显著高于手术前（P〈0.05）,但手术后2~7 d、1个月患者的狭窄处PSV、RI、患侧寰椎段TAV、RI、FV之间的差异均不显著（P〉0.05）。治疗的总有效率为96.2%（50/52）,远期并发症发生率为25.0%（13/52）,脑卒中患病率为0。结论椎动脉开口狭窄介入治疗后椎动脉狭窄率显著降低,狭窄处和患侧寰椎段血流动力学状态得到有效改善,脑卒中患病率极低。Objective To explore the influence of interventional therapy in treatment of vertebral artery ostial stenosis on hemodynamic changes and prevalence of stroke. Methods The clinical data of 52 patients with vertebral artery ostial stenosis in this hospital during March 2010 to March 2013 were retrospectively analyzed, the condition of stent implantation and the incidence of perioperative complications, hemodynamic TCD, clinical efficacy and long - term complications were observed before and after surgery. Results The immediate residual stenosis rate after DSA in 52 patients （9.0±2.9% ） was significantly lower than that of preoperative stenosis rate （80.8 ±5.2）% （ P 〈0.05）. The successful rate of surgery was 100% , and the rate of perioperative corn were significantly lower than those before surgery （ P 〈 0.05 lications was 0. The stenosis PSV and RI in 2 -7 d and 1 month after the operation . TAVI and FV in ipsilateral atlas section were significantly higher than those before surgery （ P 〈0.05） , but the difference in PSV and RI in stenosis site and TAV, RI and FV in ipsilateral atlas section in 2 - 7 d and 1 month after surgery were not significant （ P 〉 0.05）. The total efficacy rate of treatment was 96.2% （50/52） , the occurrance rate of complications was 25.0% （13/52） , and the prevalence rate of storke was 0. Conclusion Interventional therapy in treatment of ostial stenosis of vertebral artery can significantly reduce the stenosis rate of vertebral artery, and effectively improve the hemodynamics in atlas segment and ipsilateral stenosis of patients, and the prevalence of stroke is very low.

关 键 词：椎动脉开口狭窄 介入治疗 血流动力学状态变化 脑卒中患病率 

分 类 号：R743.3[医药卫生—神经病学与精神病学]