摘要
目的探讨数字减影全脑血管造影术(digital subtraction angiography,DSA)在缺血性脑血管病(ischemic cerebrovascular disease,ICVD,缺血性脑卒中)诊断中的准确性,并评估DSA引导下溶栓治疗的临床疗效及预后改善情况。方法采用随机对照研究方法,纳入2022年1月至2023年1月河南中医药大学第一附属医院收治的60例ICVD患者,随机分为对照组(n=30)和研究组(n=30)。所有患者均接受CT血管成像(computed tomography angiography,CTA)和DSA检查,对照组采用常规治疗,研究组采用DSA引导下溶栓治疗。比较两组诊断准确性、临床疗效及预后指标。结果DSA在病灶检出率(86.7%vs 63.3%)和病变血管检出率(93.3%vs 70.0%)方面均显著优于CTA(P<0.05)。研究组治疗总有效率(90.0%vs 66.7%)显著高于对照组(P<0.05)。治疗后,研究组美国国立卫生研究院卒中量表评分[(4.2±1.5)vs(7.8±2.1)]和改良Rankin量表评分[(1.5±0.6)vs(2.8±0.9)]均显著低于对照组(P<0.05)。结论DSA可显著提高ICVD的诊断准确性,其引导下的溶栓治疗能够有效改善患者神经功能缺损症状,降低残疾程度,具有重要的临床应用价值。
Objective To evaluate the diagnostic accuracy of digital subtraction angiography(DSA)in ischemic cerebrovascular disease(ICVD)and assess the clinical efficacy and prognostic outcomes of DSA-guided thrombolytic therapy.Methods In this randomized controlled study,60 ICVD patients admitted to the First Affiliated Hospital of Henan University of Chinese Medicine between January 2022 and January 2023 were enrolled and randomly assigned to either a control group(n=30,conventional therapy)or a study group(n=30,DSA-guided thrombolysis).All patients underwent both computed tomography angiography(CTA)and DSA.Diagnostic accuracy,clinical efficacy,and prognostic indicators were compared between the two groups.Results DSA demonstrated significantly higher detection rates for ischemic lesions(86.7%vs 63.3%,P<0.05)and affected vessels(93.3%vs 70.0%,P<O.05)compared with CTA.The study group exhibited a significantly higher overall treatment response rate(90.0%vs 66.7%,P<0.05).Post-treatment assessments revealed that the study group had significantly lower National Institutes of Health Stroke Scale scores[(4.2±1.5)vs(7.8±2.1),P<0.05]and modified Rankin scale scores[(1.5±0.6)vs(2.8±0.9),P<0.05]compared to the controlgroup.Conclusion DSAsignificantly improves the diagnostic accuracy of ICVD,and DSA guided thrombolysis effectively enhances neurological recovery while reducing disability severity,demonstrating substantial clinical value for widespread application.
作者
高曙光
闫奎坡
李文佳
杨蕙毓
马会华
GAO Shu-guang;YAN Kui-po;LI Wen-jia;YANG Hui-yu;MA Hui-hua(Heart Center/National Regional(Traditional Chinese Medicine)Cardiovascular Diagnosis and Treatment Center,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou,Henan 450000,China;the First Clinical Medical College,Henan University of Chinese Medicine,Zhengzhou,Henan 450000,China;Henan Collaborative Innovation Center,Prevention and Treatment of Major Diseases with Integrated Traditional Chinese and Western Medicine,Zhengzhou,Henan 450000,China)
出处
《医药论坛杂志》
2026年第6期602-605,610,共5页
Journal of Medical Forum
基金
河南省中医药科学研究专项课题(2016ZY3003,2021JDZY105,2016ZY2051)。
