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目的:对比支架成形术和药物治疗重度颅内动脉狭窄老年患者的效果及安全性。方法:选择老年重度颅内动脉狭窄患者78例,根据治疗方法的不同分为观察组与对照组各39例,对照组给予内科保守治疗,观察组给予支架成形术治疗。比较2组的颅内动脉狭窄度、血流动力学指标及终点事件发生率。结果:观察组的支架成形术均成功,植入支架40枚。治疗后,对照组和观察组的颅内动脉狭窄度均低于治疗前(t=13.113,P<0.05;t=22.298,P<0.05);且观察组的颅内动脉狭窄度低于对照组(t=9.133,P<0.05)。治疗后,2组的阻力指数(RI)明显低于治疗前,搏动指数(PI)高于治疗前(P<0.05);且观察组治疗后的RI、PI值与对照组比较差异有统计学意义(P<0.05)。观察组治疗后的支架内再狭窄、缺血性卒中、颅内出血、死亡等发生率与对照组对比差异无统计学意义(P>0.05)。结论:相对于内科保守治疗,支架成形术治疗重度颅内动脉狭窄老年患者能有效缓解狭窄程度,促进脑局部供血区血流的恢复,安全性也较好。
OBJECTIVE: To compare the efficacy and safety of stenting and drug therapy for elderly patients with severe intracranial arterial stenosis. Methods: Seventy-eight elderly patients with severe intracranial arterial stenosis were divided into observation group and control group according to different treatment methods. The control group received conservative treatment and the observation group received stent-graft treatment. The severity of intracranial artery stenosis, hemodynamic parameters and incidence of end-point events were compared between the two groups. Results: The stent group in the observation group was successfully treated with 40 scaffolds. After treatment, the degree of intracranial artery stenosis in both control group and observation group was lower than that before treatment (t = 13.113, P <0.05; t = 22.298, P <0.05) (t = 9.133, P <0.05). After treatment, the resistance index (RI) of the two groups was significantly lower than that before treatment, and the pulsatility index (PI) was higher than that before treatment (P <0.05). The RI and PI of the observation group were statistically different from the control group Significance (P <0.05). The incidence of in-stent restenosis, ischemic stroke, intracranial hemorrhage and death in the observation group was not significantly different from that in the control group (P> 0.05). Conclusion: Compared with the conservative treatment of internal medicine, stenting for elder patients with severe intracranial arterial stenosis can effectively relieve the stenosis and promote the recovery of blood flow in the local cerebral blood supply area, which is also safe.