| Objectives Retrospective comparative analysis of patients with acute cerebral infarction or recurrent transient ischemic attack(TIA)due to severe stenosis of the middle cerebral artery(stenosis rate <70%),conservative medical treatment or middle cerebral artery(middle cerebral artery)Artry,MCA)stenting and other different treatment methods,to compare the long-term prognosis of clinical efficacy and cognitive function of patients.The patients were given medical treatment during acute cerebral infarction or repeated TIA,and the experimental group(stent implantation group)was given surgical treatment after the patients had passed the acute phase.Methods Patients admitted to the Department of Neurology of Hebei Provincial People's Hospital from May 2016 to May 2019 with acute cerebral infarction or recurrent TIA episodes due to severe stenosis of the middle cerebral artery(stenosis rate <70%)were collected.The presence of severe stenosis of the middle cerebral artery on one side(stenosis rate <70%)was confirmed by auxiliary examination.Patients were divided into experimental group(n=29)and control group(n=37)according to whether they underwent middle cerebral artery stenting or not.The baseline data,m RS score,NIHSS score and related indicators of interventional surgery were analyzed in both groups.The change of cognitive function of patients was analyzed,and the patients were also divided into experimental group(n=21)and control group(n=23)according to the procedure of middle cerebral artery stenting.Results In the analysis of safety and effectiveness of middle cerebral artery stenting,the general baseline data of patients with middle cerebral artery stenosis followed up for 1 year were not statistically different between the experimental group and the control group(P > 0.05),and there were no statistical differences in hypertension,diabetes,BMI value,NIHSS score and m RS score.There was a statistically significant difference in the 1-year endpoint mortality/recurrent stroke rate between patients [1(3.4%)vs.8(21.60%)P=0.033].Recurrent recurrent TIA episodes: [2(6.9%)vs.3(8.11%)P=0.854].The difference was not statistically significant.Secondary endpoints in the experimental and control groups were bleeding after one year: [1(3.4%)vs.2(5.41%)P=0.705],secondary seizures: [1(3.4%)vs.1(2.7%)P=0.861],coma: [1(3.4%)vs.1(2.7%)P=0.861].The difference was not statistically significant.In the analysis of the effect of middle cerebral artery stenting on cognitive impairment,the general baseline data were not statistically significant.The patients with severe stenosis of middle cerebral artery with cognitive impairment were observed.The cognitive function scale Mo CA was evaluated before stenting and 1 month and 6 months after stenting,respectively.The cognitive function scale was measured before and 1 month and 6 months after stenting in the drug treatment group.And were compared between groups.It was concluded that there was no significant difference between the two groups before operation [24.10 ± 1.55 vs.24.09 ± 1.08,P = 0.984].There was no significant difference between the two groups at 1 month after operation [24.81 ±1.91 vs.24.52 ±2.31,P = 0.657].Six months after operation [25.95 1.77 vs.24.04 1.77,P = 0.001],the difference was statistically significant.Conclusions 1.For patients with cerebral infarction caused by middle cerebral artery stenosis,middle cerebral artery stenting is a strategy for the treatment of atherosclerotic stenosis,which can effectively improve the blood flow at the site of criminal vessels.2.Medical treatment is atherosclerotic middle cerebral artery stenosis with no surgical risk and higher safety.When the surgical indications of patients and the operation level of operators reach a certain height under strict control,some patients still have unstable symptomatic hemodynamics after active drug treatment,which can benefit from active vascular intervention.3.For patients with severe stenosis of one middle cerebral artery accompanied by cognitive dysfunction,middle cerebral artery stenting can improve blood flow of criminal vessels and increase blood volume in the blood supply area.Compared with conservative medical treatment,it can effectively improve cognitive function of patients.Figure 0,Table 5,Reference 180... |
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