介入治疗颅内前循环动脉粥样硬化性狭窄的临床疗效

目的探讨介入治疗与药物治疗颅内前循环动脉狭窄的临床疗效。方法回顾性分析重度前循环颅内动脉粥样硬化性狭窄而导致的脑梗死或短暂性脑缺血发作患者166例的临床资料,根据患者治疗方法分为介入组（81例）和药物组（85例）。比较两组患者随访期间累积主要终点事件和次要终点事件发生率。结果两组主要终点事件累积发生率比较差异无统计学意义（P〉0.05）。不考虑围手术期并发症,以30 d后责任血管同侧缺血性脑血管事件作为次要终点事件,随访3年时两组累积发生率比较,差异有统计学意义（P〈0.01）。结论介入治疗重度颅内前循环动脉狭窄对30 d后责任血管同侧缺血性脑卒中的预防作用更优于单纯药物治疗,介入治疗的围手术期并发症仍然是限制其临床推广的主要因素。

Clinical efficacy of interventional treatment of intracranial atherosclerotic anterior circulation stenosis

Objective To discuss clinical of efficacy of interventional treatment of intracranial atherosclerotic anterior circulation stenosis. Methods Clinical data of 166 cases with infarction or transient ischemic attack caused by before severe intracranial atherosclerosis circulation stenosis were retrospectively analyzed, and all patients were divided into interventional group（81 cases） and drug group（85 cases） according to treatment. Cumulative primary endpoint and secondary endpoint event rates during the follow-up were compared. Results Cumulative primary endpoint of two groups showed no significant differece（P〉0.05）. Without considering perioperative complications, after 30 d responsibility vascular ipsilateral ischemic cerebrovascular events as secondary endpoint events, cumulative secondary endpoint event rates at follow-up of 3 years of two groups showed significant difference（P〈0.01）. Conclusion Preventive effect of interventional treatment of intracranial atherosclerotic anterior circulation stenosis is better than simple drug treatment, and interventional treatment of peri-operative complications is still the main factors for limiting its clinical promotion.