球囊预扩张联合药物洗脱支架治疗椎动脉起始部狭窄患者的疗效观察  

Observation of the therapeutic efficacy of balloon pre-dilation combined with drug-eluting stent treatment for patients with stenosis of vertebral artery origin

作　　者：周艳丽 尤丽玲 徐程华 Zhou Yanli;You Liling;Xu Chenghua(Department of Neurology,Taizhou First People's Hospital,Taizhou 318020,China)

机构地区：[1]浙江省台州市第一人民医院神经内科,318020

出　　处：《心脑血管病防治》2023年第10期5-9,共5页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：浙江省医药卫生科技计划项目(2020KY1041)。

摘　　要：目的探讨球囊预扩张联合药物洗脱支架治疗椎动脉起始部狭窄患者的安全性和有效性。方法收集2015年1月至2018年12月在台州市第一人民医院行椎动脉起始部支架置入术的患者152例,随访1年,失访6例,根据置入支架的种类分为药物洗脱支架组48例和金属裸支架组98例,比较两组患者的一般资料、随访期内两组的新发症状和支架内再狭窄率。根据有无支架内再狭窄分为再狭窄组和无再狭窄组,比较两组患者的新发症状。结果药物洗脱支架组患者年龄比金属裸支架组更小(t=2.170,P<0.05);1年随访期内药物洗脱支架组比金属裸支架组的支架内再狭窄率及新发症状更低,差异有统计学意义(χ^(2)=4.435、5.204,P<0.05);2年随访期内药物洗脱支架组比金属裸支架组的支架内再狭窄率及新发症状均更低,差异有统计学意义(χ^(2)=4.345、6.062,P<0.05);与无再狭窄患者比较,支架内再狭窄患者在1年随访期内和2年随访期内均出现更多新发症状病例,差异有统计学意义(χ^(2)=13.042、14.368,P<0.01)。结论球囊预扩张联合药物洗脱支架比金属裸支架治疗椎动脉起始部狭窄,支架内再狭窄率更低,新发症状更少。Objective To assess the efficacy and safety of balloon pre-dilation combined with drug-eluting stents(DES)treatment for patients with stenosis of vertebral artery origin(VAOS).Methods A total of 152 patients who underwent VAOS placement at Taizhou First People's Hospital from January 2015 to December 2018 were enrolled,and followed up for 1 year,with 6 cases lost to follow-up.Based on the type of stent implanted,the patients were divided into two groups:the DES group(48 cases)and the bare-metal stent group(98 cases).Baseline data of the two groups,as well as the incidences of new symptoms and in-stent restenosis rates during the follow-up period were compared.According to the presence of in-stent restenosis,patients were further divided into the restenosis group and the non-restenosis group,and the incidences of new symptoms between the two groups were compared.Results Patients in the drug-eluting stent group were younger than those in the bare-metal stent group(t=2.170,P<0.05).During the 1-year follow-up period,the DES group had a lower rate of in-stent restenosis and lower incidence of new symptoms than the bare-metal stent group,with statistically significant differences(χ^(2)=4.435,5.204;P<0.05).During the 2-year follow-up period,the DES group had a lower rate of in-stent restenosis and lower incidence of new symptoms than the bare-metal stent group,with statistically significant differences(χ^(2)=4.345,6.062;P<0.05).Compared with patients with non-restenosis,patients with in-stent restenosis had more cases of new symptoms during both the 1-year and 2-year follow-up periods,with statistically significant differences(χ^(2)=13.042,14.368;P<0.01).Conclusion Compared with bare-metal stent implantation,balloon pre-dilation combined with DES in the treatment of VAOS has a lower rate of in-stent restenosis and fewer new symptoms.

关 键 词：球囊预扩张 药物洗脱支架 椎动脉起始部 金属裸支架 

分 类 号：R743.3[医药卫生—神经病学与精神病学]