支架成形术与单纯药物治疗老年症状性椎动脉狭窄患者的疗效比较  

Comparative Study between Stenting and Medication for Treatment of Symptomatic Vertebral Artery Stenosis in the Elderly

作　　者：王俊 严永兴 钟长扬 张艳 魏颖楠 WANG Jun;YAN Yong_xing;ZHONG Chang-yang(Department of Neurology,Hangzhou Clinical College of Medical University Of Anhui,Zhejiang 310009,China)

机构地区：[1]浙江省杭州市第三人民医院神经内科,安徽医科大学杭州临床学院,310009

出　　处：《心脑血管病防治》2018年第2期114-117,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：浙江省杭州市科技局科技计划资助项目(编号:20150733Q29);浙江省杭州市卫生科技计划项目(编号:2015A16)

摘　　要：目的探讨血管内支架成形术治疗老年症状性椎动脉中重度狭窄患者的长期疗效。方法回顾性分析22例支架成形术及12例单纯药物治疗的老年症状性椎动脉中重度狭窄患者的临床资料,分析支架成形术组患者围手术期并发症发生率以及随访期内两组患者血管狭窄程度、再狭窄率、神经功能恢复情况、脑缺血事件发生率等对比其疗效。结果临床随访73~104个月,平均(90.41±10.86)个月,支架成形术组患者围手术期无严重并发症发生。治疗前两组患者血管狭窄率(82.50±9.17)%vs(79.83±6.42)%,差异无统计学意义(P>0.05);随访期末支架成形术组患者血管狭窄程度(9.00±15.85)%,显著低于药物治疗组(84.83±10.63)%,差异有统计学意义(P<0.01);支架成形术组有3例出现支架内狭窄,药物组有3例患者完全闭塞;随访期内支架成形术组患者总的缺血事件3例,明显低于药物治疗组8例(P<0.01)。结论支架成形术治疗老年症状性椎动脉中重度狭窄有较好的长期效果,对预防后循环缺血事件优于单纯药物治疗,但仍需要更大样本量对照研究证实。ObjectiveTo investigate the long_term efficacy of Endovascular stent_assistant angioplasty(ESAA)in the elderly patients with symptomatic moderateand severe vertebral artery stenosis,and compare the efficacy with the single medication treatment.Methods Retrospective analysis of 34 hospitalized patients withsymptomatic moderate and severe vertebral artery stenosis.According to different treatment methods,they were divided into 22 cases of ESAA group and 12 cases of single medication treatment group.During the follow_up period,the degreeof vascular stenosis,restenosis rate,recovery of neurological function and theincidence of cerebral ischemic events in the two groups were analyzed.ResultsThe average clinical follow_up period was(90.41±10.86)months(range 73~104months).There are no serious complications occurred during the perioperative period in ESAA group.Before treatment,the stenosis rate of two groups(82.50%±9.17%VS 79.83%±6.42%)weren’t statistically significant(P>0.05),During follow_up period,the stenosis rate was significantly lower than the medication treatment group(P<0.01)In ESAA group,3 cases had stent stenosis,and 3 cases inthemedication treatment group were completely occluded.There were 3 cases of tischemic events in ESAA group,compared with 8 cases in the medication treatment group,the difference was statistically significant(P<0.05).Conclusions ESAA has a long_term effect in the treatment of symptomatic moderate and severe vertebral artery stenosiss.It is superior to single medication therapy in preventing posterior circulation ischemia,however more large_sample trial is required.

关 键 词：支架 椎动脉 狭窄 治疗 随访 

分 类 号：R543.5[医药卫生—心血管疾病] R815[医药卫生—内科学]