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目的观察并探讨颈动脉狭窄支架成形术(carotid artery stenosis stenting,CASS)对缺血性脑卒中(ischemic stroke,ICS)的预防价值。方法选择自2010年2月—2013年12月在温岭市第一人民医院治疗的颈动脉狭窄(carotid artery stenosis,CAS)患者96例,按照随机分组法将其分为2组,观察组和对照组各48例,对照组给予单纯药物治疗,观察组接受CASS术治疗。治疗前后监测2组患者的甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)和CAS程度,并随访统计2组预后情况。结果治疗前,2组患者血脂水平相比差异不具有统计学意义(P>0.05);治疗后,观察组TG、TC、LDL分别为(1.42±0.36)mmol/L、(3.15±0.32)mmol/L和(2.01±0.24)mmol/L,对照组为(1.76±0.43)mmol/L、(3.96±0.92)mmol/L和(2.52±0.34)mmol/L,2组相比差异具有统计学意义(P<0.05);观察组CAS重度率为2.1%(1/48),对照组为18.8%(9/48),2组差异具有统计学意义(P<0.05);观察组颈动脉短暂性缺血发作(transient ischemic attack,TIA)、ICS、新发梗死及病死率均明显低于对照组(P<0.05)。结论对CAS患者实施CASS术有利于控制狭窄程度,并预防ICS的发生,是安全有效的治疗方法。
Objective To observe and evaluate the preventive effect of carotid artery stenosis stenting (CASS) on ischemic stroke (ICS). Methods A total of 96 patients with carotid artery stenosis (CAS) treated in Wenling First People’s Hospital from February 2010 to December 2013 were divided into two groups according to randomization method. The observation group and control group 48 cases in each group. The control group received simple drug treatment and the observation group received CASS. The levels of triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL) and CAS in the two groups before and after treatment were monitored. The prognosis of the two groups were followed up. Results Before treatment, there was no significant difference in blood lipid levels between the two groups (P> 0.05). After treatment, TG, TC and LDL in the observation group were (1.42 ± 0.36) mmol / L and (3.15 ± 0.32) mmol / (2.01 ± 0.24) mmol / L and (1.76 ± 0.43) mmol / L and (3.96 ± 0.92) mmol / L and (2.52 ± 0.34) mmol / L respectively in the control group.The difference between the two groups was statistically significant (P <0.05). The CAS severe rate was 2.1% (1/48) in the observation group and 18.8% (9/48) in the control group, with significant difference between the two groups (P <0.05) Transient ischemic attack (TIA), ICS, new infarction and mortality were significantly lower than those in the control group (P <0.05). Conclusion It is safe and effective to implement CASS for patients with CAS in order to control the degree of stenosis and prevent the occurrence of ICS.