阿司匹林联合氯吡格雷与血管内支架治疗症状性颅内动脉狭窄的效果比较

摘要

目的 比较阿司匹林联合氯吡格雷与血管内支架治疗症状性颅内动脉狭窄的效果.方法 选取2013年7月～2015年6月河北省沧州市中心医院收治的症状性颅内动脉狭窄患者75例,根据患者治疗方式分为对照组与研究组,对照组44例给予阿司匹林联合氯吡格雷治疗,研究组31例行血管内支架治疗.比较两组临床疗效,观察两组末次随访时短暂性脑缺血复发率与新发脑梗死率,比较两组治疗前和末次随访时美国国立卫生研究院卒中量表(NIHSS)评分及ADL评分.结果 研究组总有效率为96.77％,明显高于对照组的77.27％,差异有统计学意义(P＜0.05).两组短暂性脑缺血复发率比较,差异无统计学意义(P＞0.05).研究组新发脑梗死率为3.25％,低于对照组的25.00％,差异有统计学意义(P＜0.05).两组末次随访时NIHSS评分均较治疗前降低(P＜0.05),研究组降低幅度较对照组明显(P＜0.05);两组末次随访时ADL评分均较治疗前升高(P＜ 0.05),研究组升高幅度较对照组明显(P＜0.05).结论 血管内支架治疗症状性颅内动脉狭窄的效果显著,新发脑梗死率低且安全性高,值得临床推广应用.%Objective To compare effect of Aspirin combined with Clopidogrel and intravascular stent in the treatment of symptomatic intracranial arterial stenosis.Methods 75 patients with symptomatic intracranial arterial stenosis treated in Cangzhou Central Hospital of Hebei Province from July 2013 to June 2015 were selected and divided into control group and study group according to treatment ways of patients.Control group of 44 cases were given Aspirin combined with Clopidogrel treatment,and study group of 31 cases were given intravascular stent treatment.Clinical effects were contrasted in two groups,transient ischemic attack recurrence rate and new cerebral infarction rate in the last follow up between two groups were observed.NIHSS and ADL scores before treatment and the last follow-up between two groups were compared.Results Total effective rate in study group was 96.77％,significantly higher than that in control group (77.27％),with statistical difference (P ＜ 0.05).Transient ischemic attack recurrence rate between two groups was compared,with no statistical difference (P ＞ 0.05).New cerebral infarction rate in study group was 3.25％,lower than that in control group (25.00％),with statistical difference (P ＜ 0.05).NIHSS scores of two groups at the last follow-up were lower than before treatment (P ＜ 0.05),study group was significantly lower than control group (P ＜ 0.05).ADL scores of two groups were higher than before treatment (P ＜ 0.05),study group was significantly higher than control group (P ＜ 0.05).Conclusion The effect is obvious of endovascular stent in the treatment of symptomatic intracranial arterial stenosis,with low new cerebral infarction rate and high safety.It is worthy of clinical popularization and application.