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目的探讨介入治疗对伴重度颈动脉颅外段狭窄的脑梗死患者认知功能、神经功能缺损状况及脑卒中复发预后的近期影响。方法65例颈动脉颅外段重度狭窄的脑梗死患者采用自膨式支架行经皮血管内成形及支架置入术(PTAS),为介入组;另外74例颈动脉颅外段重度狭窄的脑梗死患者仅接受药物治疗,为对照组。分组依据患者治疗意愿,即是否同意接受PTAS,对两组患者进行6个月随访,观察患者NIHSS、MMSE评分变化,记录脑卒中和死亡事件。结果两组患者一般资料及预后相关因素分布并无显著差异,合并其他脑动脉狭窄分布也无显著差异;入组时NIHSS、MMSE评分无显著差异,但介入组3个月、6个月NIHSS评分显著低于对照组,MMSE评分显著高于对照组(P<0.05);随访期间介入组脑卒中复发率低于对照组,但无显著差异(P>0.05)。结论 PTAS是颈动脉颅外段狭窄患者改善康复预后的有效措施,并可能降低脑卒中复发率。
Objective To investigate the short-term effects of interventional therapy on cognitive function, neurological deficit and prognosis of stroke in patients with severe cerebral carotid stenosis. Methods Sixty-five patients with severe stenosis of the extracranial carotid artery were treated with percutaneous transluminal angioplasty (PTAS) and self-expanding stent (PTAS) for the intervention group. Another 74 patients with severe stenosis of the extracranial carotid artery Patients received only medication for the control group. The patients were followed up for 6 months on the basis of the patients’ willingness to treat, whether they agreed to receive PTAS or not. The NIHSS and MMSE scores of the patients were observed, and the stroke and death were recorded. Results There was no significant difference in the distribution of general information and prognosis between the two groups. There was no significant difference in the distribution of other cerebral arterial stenosis between the two groups. There was no significant difference in NIHSS and MMSE scores between the two groups. However, NIHSS scores of 3 months and 6 months MMSE score was significantly lower than that of the control group (P <0.05). The recurrence rate of intervention stroke group was lower than that of the control group during follow-up, but there was no significant difference (P> 0.05). Conclusion PTAS is an effective measure to improve the prognosis of patients with extracranial carotid stenosis and may reduce the recurrence rate of stroke.