目的 探討缺血性腦血管病患者高同型半胱氨酸(Hcy)血癥與顱內外動脈狹窄的關系。 方法 2007年6月-2009年12月收治缺血性腦血管病患者90例，根據全腦血管造影檢查結果分為顱內外動脈狹窄組和顱內外動脈無狹窄組；顱內外動脈狹窄組依狹窄部位分為單純顱內動脈狹窄組、單純顱外動脈狹窄組及顱內外動脈均有狹窄組；分析各組同型半胱氨酸的水平。 結果 顱內外動脈狹窄組血漿Hcy水平顯著高于顱內外動脈無狹窄組(Plt;0.05)；單純顱內動脈狹窄組、單純顱外動脈狹窄組及顱內外動脈均有狹窄組血漿Hcy水平均顯著高于顱內外動脈無狹窄組(Plt;0.05)。 結論 高同型半胱氨酸血癥是顱內外動脈狹窄的危險因素，是單純顱內動脈狹窄及單純顱外動脈狹窄的共同危險因素。
ObjectiveTo evaluate the prognosis of interventional treatment with covered stent graft for retrograde Stanford type A aortic dissection and intramural hematoma by single-arm meta-analysis.MethodsRelated studies on treating retrograde Stanford type A aortic dissection and intramural hematoma with covered stent graft were retrieved from the databases by computer, including PubMed, EMbase, The Cochrane Library, Wanfang Data, VIP, CNKI and CBM, from inception to January 2020. Literatures were screened by researchers step by step according to the predefined inclusion and exclusion criteria. Quality of the enrolled literatures was evaluated, and data were extracted from the included studies. Afterwards, single-arm meta-analysis was carried out by the R3.6.3 software.ResultsA total of 12 English and 5 Chinese studies were included, which were all case series, and the quality of all literatures was moderate evaluated by Newcastle-Ottawa Scale (NOS). After analyzing the clinical prognosis of 260 patients, the 30-day mortality was 6% (95%CI 0.04 to 0.11, P=0.97), the late mortality was 8% (95%CI 0.05 to 0.14, P=0.78), the incidence of endoleak was 21% (95%CI 0.16 to 0.29, P=0.06), the incidence of stroke was 5% (95%CI 0.03 to 0.09, P=0.99), the incidence of new aortic dissection was 7% (95%CI 0.04 to 0.11, P=0.96), the incidence of dissection progression was 10% (95%CI 0.07 to 0.16, P=0.24), and the absorption rate of intramural hematoma was 84% (95%CI 0.37 to 1.00, P<0.01).ConclusionInterventional treatment with covered stent graft for retrograde Stanford type A aortic dissection and intramural hematoma can obtain good early treatment results for some patients, and can be used as a safe and effective treatment for aged patient with high risk who cannot tolerate surgery. Endoleak, stroke and new aortic dissection are the early serious complications of this method.