支架成形术治疗症状性重度颅内动脉狭窄的效果及预后影响因素分析  

Effect of Stent-assisted Angioplasty in the Treatment of Symptomatic Severe Intracranial Artery Stenosis and Analysis of Influence Factor of Prognosis

作　　者：梁建锋[1] 李剑 LIANG Jianfeng;LI Jian(Beijing Fangshan District First Hospital,Beijing 102400,China;不详)

机构地区：[1]北京市房山区第一医院,北京102400

出　　处：《中外医学研究》2023年第34期159-163,共5页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:研究支架成形术(stent-assisted angioplasty,SAA)治疗症状性重度颅内动脉狭窄的效果,分析预后影响因素。方法:回顾性选取2018年1月—2022年1月北京市房山区第一医院收治的120例症状性重度颅内动脉狭窄患者的资料。根据不同的治疗方法将其分为支架组及参考组,各60例。收集两组一般资料,支架组给予SAA治疗,参考组给予药物治疗。比较两组治疗前1 d、治疗90 d残疾程度、神经功能,预后不良。对症状性重度颅内动脉狭窄患者预后不良进行单因素及多因素分析。结果:治疗90 d,两组改良Rankin量表(modified Rankin scale,mRS)及美国国立卫生研究院卒中量表(national institutes of health stroke scale,NIHSS)评分均低于治疗前1 d,差异有统计学意义(P<0.05),两组mRS评分及NIHSS评分比较,差异无统计学意义(P>0.05)。两组预后不良发生率比较,差异无统计学意义(P>0.05)。预后不良患者男性、吸烟及基底动脉病变占比均高于预后良好患者,差异有统计学意义(P<0.05)。吸烟、基底动脉病变均是症状性重度颅内动脉狭窄预后不良的危险因素(OR>1,P<0.05)。结论:SAA治疗症状性重度颅内动脉狭窄的效果与药物治疗相当。此外,吸烟及病变血管部位均可能影响该病患者预后,应予以重点关注。Objective:To study the effect of stent-assisted angioplasty(SAA)in the treatment of symptomatic severe intracranial artery stenosis and to analyze the influence factor of prognosis.Method:The data of 120 patients with symptomatic severe intracranial artery stenosis admitted to the Beijing Fangshan District First Hospital from January 2018 to January 2022 were retrospectively selected.According to different treatment methods,the patients were divided into stent group and reference group,60 cases in each group.General data of two groups were collected,the stent group was given SAA treatment,and the reference group was given drug treatment.The degree of disability,neurological function 1 d before treatment and 90 d of treatment and poor prognosis were compared between the two groups.The poor prognosis of symptomatic intracranial artery stenosis was analyzed by univariate and multivariate analysis.Result:At 90 d of treatment,the scores of the modified Rankin scale(mRS)and National Institutes of Health stroke scale(NIHSS)in both groups were lower than those 1 d before treatment,the difference was statistically significant(P<0.05),there was no statistically significant difference in mRS and NIHSS scores between the two groups(P>0.05).There was no statistically significant difference in the incidence of poor prognosis between the two groups(P>0.05).The proportions of male,smoking,and basilar artery lesions in patients with poor prognosis were higher than those of patients with good prognosis,and the differences were statistically significant(P<0.05).Smoking and basilar artery disease were both risk factors for poor prognosis of symptomatic severe intracranial artery stenosis(OR>1,P<0.05).Conclusion:The therapeutic effect of SAA in the treatment of symptomatic severe intracranial arterial stenosis is equivalent to that of drug therapy.In addition,smoking and the location of vascular lesions may affect the prognosis of patients with this disease,which should be paid more attention to.

关 键 词：症状性重度颅内动脉狭窄 支架成形术 效果 预后 影响因素 

分 类 号：R651.12[医药卫生—外科学]