卫 飞 卢 丽 李光勤

    重庆医科大学附属第一医院神经内科，重庆 400016

    颅内动脉粥样硬化性狭窄诊治现状

    卫飞卢丽李光勤▲

    重庆医科大学附属第一医院神经内科，重庆400016

    颅内动脉粥样硬化性狭窄是我国缺血性卒中最常见原因之一，治疗手段包括药物治疗和支架治疗。在WASID、SPARCL、CHANCE、SAMMPRIS等研究的推动下，常规药物治疗过渡到强化药物治疗，包括双抗血小板药物、强化他汀治疗等。同时，SAMMPRIS、VISSIT研究证实颅内支架置入并不获益，而国内的颅内支架研究认为可以接受，东西方观点差异明显。传统影像学检查用以发现血管狭窄，而高分辨率MRI可用来评价颅内动脉粥样硬化斑块病理性质和稳定性，可用于卒中风险分层。本文对颅内动脉粥样硬化性狭窄诊疗研究的重要进展进行综述，以期了解其最新临床诊疗现状。

    颅内粥样硬化；动脉狭窄；诊断；治疗

    [Abstract]The intracrania1 atherosc1erotic stenosis is one of the commonest causes of ischemic stroke.The treatments inc1ude medicine therapy and the stenting therapy.Evidences from WASID，SPARCL，CHANCE，SAMMPRIS tria1s，etc，support aggressive medicine administration，especia11y dua1-antip1ate1et and intensive statin therapy.Meanwhi1e SAMMPRIS and VISSIT tria1s doesn't show benefit of intracrania1 stenting whi1e Chinese tria1s do.Intracrania1 stenting is in great debate for its safety and efficiency with a big gap between East and West.Traditiona1 image1ogica1 examinations are used for identifying the vesse1 stenosis，whi1e high-reso1ution magnetic resonance imaging may identify the intracrania1 atherosc1erotic p1aque by patho1ogica1 features and vu1nerabi1ity ......