药物涂层支架与内科药物治疗症状性颅内动脉粥样硬化性重度狭窄的比较研究  

Comparative Study of Drug-coated Stents and Medical Drugs in the Treatment of Symptomatic Severe Intracranial Atherosclerotic Stenosis

作　　者：杨炯 刘慧斌[3] 崔凯 樊宇[2] 付娇 李芳雪 殷飞翔 姜长春 YANG Jiong;LIU Huibin;CUI Kai;FAN Yu;FU Jjao;LI Fangxue;YIN Feixiang;JIANG Changchun(Department of Neurology,School of Clinical Medicine,center of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014040 China;Department of Neurology,Baotou Central Hospital,Baotou 014040 China;Department of Neurology,Bayannur Hospital,Bayannur 015000 China;Department of Interventional Medicine,Inner Mongolia General Forestry Hospital,Hu-lunbuir 021000 China)

机构地区：[1]内蒙古科技大学包头医学院中心临床医学院神经内科,内蒙古包头014040 [2]包头市中心医院神经内科,内蒙古包头014040 [3]巴彦淖尔市医院神经内科,内蒙古巴彦淖尔015000 [4]内蒙古林业总医院介入科,内蒙古呼伦贝尔021000

出　　处：《内蒙古医学杂志》2023年第7期788-794,共7页Inner Mongolia Medical Journal

基　　金：内蒙古医科大学联合项目资助(编号:YKD2021LH089);包头市卫生健康科技计划(编号:wsjkkj2022027)。

摘　　要：目的观察药物涂层支架联合内科药物治疗对症状性颅内动脉粥样硬化性重度狭窄患者脑梗死的预防作用。方法本研究为一项单中心、前瞻性研究。选取2021年7月至2022年11月在包头市中心医院住院治疗的脑梗死患者,经脑血管造影或头颈部CTA检查确诊为颅内责任病变,血管狭窄程度70%~99%(WASID法判断狭窄程度)。符合入组标准的患者共39例。采用药物涂层支架(Maurora■)联合内科药物治疗或单纯内科药物治疗策略,将其分为药物涂层支架组与标准药物治疗组,并于术后6个月进行随访,观察患者有无脑梗死复发。应用SPSS25.0统计软件进行统计学分析,观察两组术后30d内的脑卒中(缺血性/出血性卒中)、31~180d内靶血管供血区域的缺血性卒中发生情况等。结果研究共纳入40例患者,其中39例(97.5%)完成了试验。药物涂层支架组与标准药物治疗组在30d内卒中复发或死亡风险及31~180d靶血管供血区域卒中风险方面差异无统计学意义(P>0.05)。结论在症状性颅内动脉粥样硬化性重度狭窄患者中,与单纯药物强化治疗相比,使用药物涂层支架联合强化药物治疗,30d内卒中或死亡风险及30~180d靶血管供血区域的卒中风险差异无统计学意义。本研究结果不支持采用药物涂层支架联合强化药物治疗症状性颅内动脉粥样硬化性重度狭窄患者。Objective To observe the preventive effect of drug-coated stent combined with medical drug therapy on cerebral infarction in patients with symptomatic intracranial atherosclerotic severe stenosis.Methods This is a single-center,prospective study.Patients with cerebral infarction who were hospitalized in Baotou Central Hospital from July 2021 to November 2022 were included.They were confirmed as intracranial responsi-ble lesions by cerebral angiography or head and neck CTA examination,and the degree of vascular stenosis was 70%~99%(the WASID method was used to determine the degree of stenosis).A total of 39 patients were en-rlled.The drug-coated stent(Maurora■)combined with medical drug therapy or simple medial drug therapy strategy was used,they were divided into drug-eluting stent group and standard drug treatment group,and the patients were followed up for 6 months to observe the recurrence of cerebral infarction.Statistical analysis was performed using SPSS 25.0 statistical software to observe stroke(ischemic/hemorrhagic stroke)within 30 days after surgery and ischemic stroke in the target blood supply area from 31 days to 180 days between the two groups.Results Of the 40 patients included in the study,39(97.5%)completed the trial.There was no sig-nificant difference in the risk of stroke recurrence or death within 30 days or the risk of stroke in the target blood supply area from 31 days to 180 days between the drug-eluting stent group and the standard drug treatment group(P>0.05).Conclusion In patients with symptomatic severe stenosis of intracranial atherosclerotic arter-ies,there was no significant difference in the risk of stroke or death within 30 days or the risk of stroke in the target blood supply area from 30 days to 6 months after the use of drug-eluting stents combined with intensive drug therapy compared with drug-enhanced therapy alone.The results of this study do not support the treat-ment of patients with symptomatic intracranial atherosclerotic severe stenosis with drug-coated stents combine

关 键 词：颅内动脉粥样硬化性狭窄 药物涂层支架 雷帕霉素药物洗脱支架 支架内再狭窄 

分 类 号：R651.1[医药卫生—外科学] R543.5[医药卫生—临床医学]