内科

目的比较介入血管支架成形术与药物保守治疗老年缺血性脑血管疾病患者的短期、长期效果。方法选取2014年3月至2016年10月在我院诊治的老年缺血性脑血管疾病患者85例为研究对象，根据患者意愿分为介入组（29例）和保守组（56例），分别给予介入血管支架成形术治疗和药物保守治疗。随访12个月，检测比较两组患者病变血管的收缩期峰流速（Vs）、神经功能缺损（NIHSS评分）、脑血管不良事件发生情况。结果治疗3、12个月后，介入组患者颈总动脉、颈内动脉、基底动脉、椎动脉的Vs均显著降低，介入组患者各动脉的Vs均显著低于保守组，差异有统计学意义（P＜0.05）；保守组患者颈总动脉、颈内动脉、基底动脉、椎动脉的Vs在治疗前后比较差异无统计学意义（P＞0.05）；介入组患者NIHSS评分显著降低，介入组患者NIHSS评分显著低于保守组，差异有统计学意义（P＜0.05）；保守组患者治疗前后NIHSS评分比较差异无统计学意义（P＞0.05）。治疗后随访12个月，介入组患者脑血管不良事件发生率（6.90%）显著低于保守组（28.57%），差异有统计学意义（P＜0.05）。结论介入血管支架成形术治疗老年缺血性脑血管疾病患者可显著改善颅脑血供、恢复神经功能、降低脑血管不良事件发生率，与药物保守治疗比较其短期和长期效果均更为显著。

ObjectiveTo investigate the short-term and long-term effects of interventional angioplasty and drug conservative treatment on senile ischemic cerebrovascular disease. Methods85 case of elderly patients with ischemic cerebrovascular disease treated in our hospital from March 2014 to October 2016 were selected as subjects. According to voluntary principle, the patients were divided into intervention group (29 cases) and conservative group (56 cases), interventional angioplasty and drug conservative treatment were given respectively. The two groups were followed up for 12 months. The systolic velocity (Vs), neurological deficit (national institute of health stroke scale score, NIHSS score) and cerebrovascular adverse events were compared between two groups. ResultsAfter 3 and 12 months of treatment, the Vs of the common carotid artery, internal carotid artery, basilar artery and vertebral artery were significantly decreased in the intervention group. The Vs of each artery in the intervention group was significantly lower than that in the conservative group, and the difference was statistically significant (P＜0.05); there was no significant difference in Vs of common carotid artery, internal carotid artery, basilar artery and vertebral artery in the conservative group before and after treatment (P＞0.05). After 3 and 12 months of treatment, the NIHSS score was significantly decreased in the intervention group, the NIHSS score in the intervention group was significantly lower than that in the conservative group (P＜0.05). There was no significant difference in the NIHSS score in the conservative group before and after treatment (P＞0.05). After 12 months of follow-up, the incidence of cerebrovascular adverse events (6.90 %) in the intervention group was significantly lower than that in the conservative group (28.57%), and the difference was statistically significant (P＜0.05). ConclusionInterventional angioplasty for elderly patients with ischemic cerebrovascular disease can significantly improve blood supply to the brain, restore nerve function, and reduce the incidence of cerebral vascular adverse events. The short-term and long-term effects of interventional angioplasty are remarkable than conservative treatment.