[1]唐　铸　桂　铮　李延良　赵建伍　余天垒　张鹏飞　赵立文　于耀宇.药物PAS与支架置入术治疗症状性颈动脉重度狭窄的近期疗效对比分析[J].中国临床神经外科杂志,2015,(12):727-729.[doi:10.13798/j.issn.1009-153X.2015.12.007]
　TANG Zhu,GUI Zheng,LI Yan-liang,et al.Comparison of clinical effect of intensive therapy with PAS on severe symptomatic carotid artery stenosis with that of carotid artery stenting[J].,2015,(12):727-729.[doi:10.13798/j.issn.1009-153X.2015.12.007]
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药物PAS与支架置入术治疗症状性颈动脉重度狭窄的近期疗效对比分析()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
期数:
2015年12期
页码:
727-729
栏目:
论著
出版日期:
2015-12-30

文章信息/Info

Title:
Comparison of clinical effect of intensive therapy with PAS on severe symptomatic carotid artery stenosis with that of carotid artery stenting
文章编号:
1009-153X（2015）12-0727-03
作者:
唐　铸　桂　铮　李延良　赵建伍　余天垒　张鹏飞　赵立文　于耀宇
300162 天津，武警后勤学院附属医院脑科医院脑血管病中心[唐　铸（华北理工大学在读硕士研究生）、桂　铮、李延良、赵建伍、余天垒、张鹏飞、赵立文、于耀宇]
通讯作者：于耀宇，E-mail：yuyaoyu666@aliyun.com
Author(s):
TANG Zhu1;  GUI Zheng2;  LI Yan-liang2;  ZHAO Jian-wu2;  YU Tian-lei2;  ZHANG Peng-fei2;  ZHAO Li-wen2;  YU Yao-yu1.
1. Graduate School, North China University of Sciences and Technology, Tangshan 063009, China; 2. Department of Neurovascular Intervention, Brain Breach Hospital, Affiliated Hospital, Logistics College of Chinese Armed Police Forces, Tianjin 300162, China
关键词:
症状性颈内动脉狭窄; 普罗布考; 阿司匹林; 他汀类药物; 药物治疗; 支架置入术; 近期疗效
Keywords:
Carotid stenosis;  Probucol;  Aspirin;  Statin;  Carotid artery stenting;  Adverse clinical events
分类号:
R 743; R 815.2
DOI:
10.13798/j.issn.1009-153X.2015.12.007
文献标志码:
A
摘要:
目的 探讨普罗布考+阿司匹林+他汀类药物（PAS）联合应用与颈动脉支架置入术（CAS）治疗症状性颈动脉重度狭窄的近期疗效差异。方法 回顾性分析2012年12月至2014年6月收治的492例症状性颈动脉重度狭窄患者的临床资料，其中采用PAS治疗（PAS组，366例）和采用CAS治疗（CAS组，126例）。评估两组患者出院后1年内严重临床不良事件（非致命性脑梗死、同侧无症状性脑卒中、短暂性脑缺血发作）发生率、次要临床不良事件（DSA示血管再狭窄较前增加>10%）发生率以及血清血脂水平变化。结果 CAS组非致命脑卒中发生率（2.3%，3/126）和短暂脑缺血发作发生率（7.9%，10/126）均明显低于PAS组[分别为（9.6%，35/366）和（15.3%，56/366）；PPP>0.05）。PAS组复诊时血清高密度脂蛋白-胆固醇（HDL-C）水平较基线水平明显增高（P<0.01），而血清低密度脂蛋白-胆固醇（ldl-c）、总胆固醇、甘油三酯水平较基线水平明显降低（>P<0.01）。cas组复诊时血清hdl-c、ldl-c、总胆固醇、甘油三酯水平和基线水平无明显差异（>P>0.05）。结论 CAS治疗相比较PAS药物强化治疗能够明显降低患者近期严重不良事件的发生率；但是，PAS药物强化治疗能够在一定程度上降低血脂水平。
Abstract:
Objective To compare the clinical effect of intensive therapy with probucol, aspirin and statin (PAS) on severe symptomatic carotid artery stenosis with that of carotid artery stenting (CAS). Methods Of 492 patients with severe symptomatic carotid artery stenoses, 366 were the intensively treated by PAS and 126 by CAS. The occurrent rates of the adverse clinical events (ACE) and blood lipid levels including high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), total cholesterol (TC) and triglyceride(TG) were compared between both the groups 1 year after discharging from the hospital. Results The occurent rate (14.3%) of serious ACE was significantly lower in the CAS group than that (34.4%) in PAS group (P<0.05) and="" the="" occurent="" rate="" (15.0%)="" of="" secondary="" clinical="" events="" (restenosis="">10%) is significantly lower in PAS group than that (34.1%) in the CAS group (P<0.05). the="" levels="" of="" ldl-c,="" tc="" and="" tg="" were="" significantly="" lower="" level="" hdl-c="" was="" higher="" after="" treatment="" than="" those="" before="" in="" pas="" group="" (P<0.01), in="" which="" the="" levels="" of="" ldl-c="" tg="" and="" tc="" were="" significantly="" lower="" than="" those="" level="" hdl-c="" was="" higher="" that="" cas="" group="" after="" treatment="" (P<0.01). there="" was="" insignificant="" difference="" in="" the="" level="" of="" blood="" lipid="" between="" before="" and="" after="" treatment="" cas="" group="" (P>0.05). Conclusions CAS may significantly reduce the incidence of severe ACE compared with the intensive therapy with PAS, which may significantly reduce the levels of LDL-C, TL and TG and increase the level of HDL-C, and has a good effect on the prevention of the progression of vascular stenosis.

参考文献/References:

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[2] Gurm HS, Yadav JS, Fayad P, et al. Long-term results of carotid stenting versus endarterectomy in high-risk patients [J]. N Engl J Med, 2008, 358(15): 1572-1579.
[3] Keyamura Y, Nagano C, Kohashi M, et al. Add-on effect of probucol in atherosclerotic, cholesterol-fed rabbits treated with atorvastatin [J]. PLoS One, 2014, 9(5): e96929.
[4] Bonati LH, Ederle J, Dobson J, et al. Length of carotid ste- nosis predicts peri-procedural stroke or death and resteno- sis in patients randomized to endovascular treatment or en- darterectomy [J]. Int J Stroke, 2014, 9(3): 297-305.
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更新日期/Last Update: 2016-12-30