Neuroform EZ支架置入对症状性大脑中动脉重度狭窄患者脑血流灌注、血管内皮功能、认知功能及神经功能缺损的干预效果

Intervention effect of Neuroform EZ stent implantation on cerebral blood perfusion, vascular endothelial function, cognitive function, and neurological deficit in patients with symptomatic severe middle cerebral artery stenosis

摘要:

目的 探讨Neuroform EZ支架置入辅助治疗症状性大脑中动脉重度狭窄的临床效果。方法 回顾性分析2016年10月至2019年10月该院症状性大脑中动脉重度狭窄患者85例临床资料，按治疗方案不同分为观察组（43例）、对照组（42例）。对照组予以单纯药物治疗，观察组在药物治疗基础上联合Neuroform EZ支架置入术。比较两组术后1年疗效、不良事件发生情况；比较两组及术前、术后6个月、术后1年认知功能评分(MMSE)、神经功能缺损程度评分(NIHSS)、脑血流灌注指标［脑血流量(CBF)、脑血容量(CBV)］、血管内皮功能指标［一氧化氮(NO)、内皮素(ET)］。结果 观察组术后1年总有效率为95.35%，高于对照组78.57%，差异有统计学意义(P<0.05)。两组术后6个月、1年MMSE评分及CBF、CBV、NO水平较术前提高，且观察组高于对照组，差异有统计学意义(P<0.05)。NIHSS评分及ET水平较术前降低，且观察组低于对照组，差异有统计学意义(P<0.05)。观察组不良事件发生率为13.95%，低于对照组33.33%，差异有统计学意义(P<0.05)。结论 Neuroform EZ支架置入辅助治疗症状性大脑中动脉重度狭窄可促进认知与神经功能改善，且在改善脑血流灌注、血管内皮功能、减少不良事件方面具有积极作用。

Abstract:

Objective To investigate the clinical effect of Neuroform EZ stent implantation as an adjuvant therapy for the treatment of symptomatic severe middle cerebral artery stenosis.Methods A retrospective analysis was performed on the clinical data of 85 patients with symptomatic severe middle cerebral artery stenosis who were admitted to the Affiliated Hospital of Chengde Medical College from October 2016 to October 2019. The patients were divided into observation group （n=43） and control group （n=42） according to their treatment regimen. The control group was given medication alone， and the observation group was given medication combined with Neuroform EZ stent implantation. The two groups were compared in terms of treatment outcome and incidence of adverse events 1 year after operation， and cognitive function score ［Mini-Mental State Examination （MMSE）］， neurological deficit score ［National Institutes of Health Stroke Scal e（NIHSS）］， cerebral blood perfusion parameters ［cerebral blood flow （CBF） and cerebral blood volume （CBV）］， and vascular endothelial function parameters ［nitric oxide （NO） and endothelin （ET）］ before operation and 6 months and 1 year after operation.Results The observation group had a significantly high eroverall response rate than the control group at 1 year after operation （95.35% vs 78.57%， P<0.05）. At 6 months and 1 year after operation， the MMSE score， CBF， CBV， and serum NO level in the two groups were significantly increased， and the separameters in the observation group were significantly higher than those in the control group （all P<0.05）； the NIHSS score and serum ET level in the two groups were significantly reduced， and these parameters in the observation group were significantly lower than those in the control group （all P<0.05）. The observation group had a significantly lower incidence rate of adverse events than the control group （13.95% vs 33.33%， P<0.05）.Conclusions Neuroform EZ stent implantation in the adjuvant treatment of symptomatic severe middle cerebral artery stenosis can promote the improvement of cognitive and neurological function， and play a positive role in improving cerebral blood perfusion， vascular endothelial function， and reducing adverse events.