[1]张栋梁,习雪峰,韩永丰,等.支架介入术联合双联抗血小板治疗颅内低灌注颅内动脉粥样硬化性狭窄临床研究[J].陕西医学杂志,2024,(4):518-522.[doi:DOI:10.3969/j.issn.1000-7377.2024.04.018]
　ZHANG Dongliang,XI Xuefeng,HAN Yongfeng,et al.Curative effect of stent intervention combined with dual anti-platelet in patients with intracranial hypoperfusion ICAS[J].,2024,(4):518-522.[doi:DOI:10.3969/j.issn.1000-7377.2024.04.018]
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支架介入术联合双联抗血小板治疗颅内低灌注颅内动脉粥样硬化性狭窄临床研究
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2024年4期
页码:
518-522
栏目:
临床研究
出版日期:
2024-04-05

文章信息/Info

Title:
Curative effect of stent intervention combined with dual anti-platelet in patients with intracranial hypoperfusion ICAS
作者:
张栋梁1; 习雪峰2; 韩永丰1; 金文才1
(1.石家庄市人民医院神经外科,河北 石家庄 050300; 2.石家庄市行唐县中医院外科,河北 石家庄 050600)
Author(s):
ZHANG Dongliang; XI Xuefeng; HAN Yongfeng; JIN Wencai
(Department of Neurosurgery,Shijiazhuang People's Hospital,Shijiazhuang 050300,China)
关键词:
支架介入术;  双联抗血小板;  颅内低灌注;  颅内动脉粥样硬化性狭窄;  神经缺损;  不良事件
Keywords:
Stent intervention;  Dual anti-platelet;  Intracranial hypoperfusion;  Intracranial atherosclerotic stenosis;  Nerve defect;  Adverse events
分类号:
R 743.1
DOI:
DOI:10.3969/j.issn.1000-7377.2024.04.018
文献标志码:
A
摘要:
目的:探究支架介入术联合双联抗血小板治疗颅内低灌注的颅内动脉粥样硬化性狭窄(ICAS)的疗效。方法:选取收治的低灌注ICAS患者186例,根据患者临床治疗方式不同分为对照组(n=102)和联合组(n=84)。对照组给予双联抗血小板方案治疗,联合组在对照组基础上采用血管内支架置入治疗,比较两组ICAS患者治疗1个月后临床疗效,经颅多普勒超声检查治疗前后动脉狭窄段收缩期峰值流速(PSV)、搏动指数(PI),采用CT脑灌注成像分析患侧脑血流速度(CBF)、 脑血容积(CBV)、平均通过时间(MTT)。神经功能缺损量表(NIHSS)和日常生活活动能力量表(ADL)于治疗前后分别评估神经功能缺损评分和日常生活能力。统计患者治疗后1年内临床不良事件发生情况。结果:联合组临床总有效率明显高于对照组(P<0.05)。治疗1个月后,联合组PSV、PI和MTT低于对照组,rCBF和rCBV高于对照组(均P<0.05)。治疗6个月后,联合组NIHSS评分低于对照组,ADL评分高于对照组(均P<0.05)。两组临床不良事件总发生率比较,差异无统计学意义(P>0.05)。结论:ICAS患者经支架介入术联合双抗血小板治疗后获得较好的疗效,有效改善颅内动脉血管狭窄情况,减轻神经缺损症状,提高日常生活能力,且短期内不会增加不良事件发生。
Abstract:
Objective:To analyze the curative effect of stent intervention combined with dual anti-platelet in intracranial hypoperfusion intracranial atherosclerotic stenosis(ICAS).Methods:A retrospective collection was performed on the clinical data of 186 patients with hypoperfusion ICAS.According to different clinical treatment methods,patients were divided into control group(n=102)and combination group(n=84).The control group was treated with dual anti-platelet regimen,while combination group was additionally treated with intravascular stent implantation.The clinical curative effect in the two groups was compared after 1 month of treatment.Before treatment and after treatment,peak systolic velocity(PSV)and Pulsability Index(PI)at arteriostenosis sites were detected by transcranial Doppler ultrasound.The cerebral blood flow(CBF),cerebral blood volume(CBV)and mean transit time(MTT)on affected side were analyzed by CT cerebral perfusion imaging.Before treatment and at 6 months after treatment,neurological impairment and activities of daily living were evaluated by National Institute of Health Stroke Scale(NIHSS)and Activity of Daily Living(ADL).The occurrence of clinical adverse events within 1 year after treatment was statistically analyzed.Results:The total clinical response rate of combination group was significantly higher than that of control group(P<0.05).After 1 month of treatment,PSV,PI and MTT in combination group were lower than those in control group,while rCBF and rCBV were higher than those in control group(all P<0.05).After 6 months of treatment,NIHSS score in combination group was lower than that in control group,and ADL score was higher than that in control group(all P<0.05).There was no significant difference in the total incidence of clinical adverse events between the two groups(P>0.05).Conclusion:Curative effect of stent intervention combined with dual anti-platelet is good in patients with ICAS,which can effectively improve intracranial artery stenosis,relieve neurological impairment symptoms,improve activities of daily living and will not increase the occurrence of adverse events in a short term.

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备注/Memo

备注/Memo:
基金项目:河北省医学科学研究课题(20201408)
更新日期/Last Update: 2024-04-07