| 袁阳李昕宇邓剑平赵振伟△ 高国栋.SPECT 对症状性颅内动脉狭窄支架成形术的疗效评价[J].,2012,12(16):3102-3106 |
| SPECT 对症状性颅内动脉狭窄支架成形术的疗效评价 |
| Therapeutic Evaluation of Intravascular Stenting in IntracranialAtherosclerotic Stenosis by SPECT Brain Perfusion Imaging |
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| DOI： |
| 中文关键词: SPECT 脑灌注显像 低灌注 症状性颅内动脉粥样硬化性狭窄 颅内支架成形术 |
| 英文关键词: SPECT brain perfusion imaging Hypoperfusion Symptomatic intracranial atherosclerotic stenosis Intracranial stenting |
| 基金项目: |
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| 中文摘要: |
| 目的：通过SPECT 脑血流灌注显像，对症状性颅内动脉粥样硬化性狭窄行颅内支架成形术，进行血流动力学的疗效评价。方
法：对42 例症状性颅内动脉粥样硬化性狭窄(狭窄程度＞50%)患者，术前通过SPECT，分为低灌注组和正常灌注组。术后3 月复
查SPECT，做出血流动力学的疗效评价。通过术前及术后1 年mRS 评分，比较两组的远期疗效。结果：低灌注组发病症状一般为
缺血性卒中，正常灌注组一般为TIA(P＜0.01)。低灌注组术后血流灌注较术前改善明显(P＜0.01)。正常灌注组复发性TIA 的发生
率较低灌注组高(P＜0.05)。低灌注组术前术后mRS 评分有统计学差异(P＜0.05)。结论：颅内支架成形术可以明确改善颅内低灌注
区的血流灌注，对低灌注组术后缺血事件的预防效果好，并有改善神经功能作用。因此，存在颅内低灌注区的患者更具有颅内支
架成形术的手术适应症。 |
| 英文摘要: |
| Objective: By use of SPECT brain perfusion imaging, the therapeutic effects of symptomatic intracranial atherosclerotic
stenosis would be assessed before and after intracranial stent-assisted angioplasty. Methods: 42 cases of symptomatic intracranial
atherosclerotic stenosis confirmed by DSA (the degree of stenosis> 50%) patients were divided into hypoperfusion group and normal
perfusion group through preoperative SPECT brain perfusion imaging before intracranial stent-assisted angioplasty. 3 months after
operation, the patients were examined with SPECT brain perfusion imaging again and made the evaluation of the cerebral hemodynamic
changes. Through the score of mRS of the two groups were evaluated before surgery and after 1-year follow-up, we compared low
perfusion group with normal perfusion group in long-term efficacy. Results: The incidence of symptoms was statistically related to
perfusion: low perfusion commonly caused ischemic stroke and ischemic events with normal perfusion were generally TIA(P＜0.01). The
perfusion was improved significantly (P <0.01) in low perfusion group compared with preoperative. The incidence of recurrent TIA in
normal perfusion group is significantly higher than low perfusion group (P <0.05). There is a significant difference between preoperative
Modified Rankin Scales and postoperative for the low perfusion group(P <0.05). Conclusion: Intracranial stent assisted angioplasty could
clearly improve the perfusion of the intracranial regions with hypoperfusion, and prevention of ischemic events in symptomatic
intracranial atherosclerotic stenosis had a better effect in stenotic-related patients with low perfusion regions. Stent-assisted angioplasty
can improve neurological function of the group for the low perfusion group. Therefore, stenotic-related patients with low perfusion
regions have more operative indications for intracranial stent-assisted angioplasty. |
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