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摘要目的评估基于MRI评价无症状性颈动脉狭窄病人斑块内出血而制定的策略的经济效益。材料与方法比较两种脑卒中预防策略:1密集的药物治疗为基础的管理策略;2成像为基础的策略:无症状性颈动脉狭窄病人中MRI发现斑块内出血者,接受直接的颈动脉内膜切除和持续的密集药物治疗。药物治疗组的病人只有颈动脉狭窄明显进展才进行颈动脉内膜切除。颈动脉狭窄程度为70%~89%和50%~69%的无症状颈动脉狭窄病人的质量调整生命年(QALYs)和费用被模型化。根据已公布的资料估计脑卒中的风险和颈动
Abstract Objective To evaluate the economic benefits of a strategy based on MRI in evaluating plaque hemorrhage in patients with asymptomatic carotid stenosis. MATERIALS AND METHODS Comparison of two strategies for prevention of stroke: 1 intensive medication-based management strategies; 2 imaging-based strategies: asymptomatic carotid stenosis in patients with plaque hemorrhage found in MRI, direct carotid endarterectomy Membrane resection and continuous intensive drug treatment. Carotid endarterectomy was performed in patients in the drug-treated group only with marked progression of carotid stenosis. Quality-adjusted life-years (QALYs) and costs for asymptomatic carotid stenosis in 70% to 89% and 50% to 69% of carotid stenoses were modeled. Estimates of stroke risk and carotid artery based on published data