Objective To compare the clinical effect on severe vertebral artery origin stenosis( VAOS) between drug therapy and stent-assisted angioplasty. Methods From January 2012 to January 2014,a total of 96 patients with severe VAOS were selected in the Department of Neurology,Cangzhou People′s Hospital,and they were randomly divided into control group and observation group,each of 48 cases. Patients of control group were treated by drug therapy,while patients of observation group were treated by stent-assisted angioplasty. Vascular stenosis rate and NIHSS score before treatment and after 12 months of discharge,incidence of vascular occlusion,new cerebral infarction and TIA after 12 months of discharge were compared between the two groups,and the safety of stent-assisted angioplasty was observed. Results No statistically significant differences of vascular stenosis rate or NIHSS score was found between the two groups before treatment ( P >0. 05 );after 12 months of discharge,vascular stenosis rate,NIHSS score,incidence of vascular occlusion,new cerebral infarction and TIA of observation group were statistically significantly lower than those of control group ( P<0. 05 ). The surgical successful rate of observation group was 97. 9%,and no one of observation occurred severe perioperative complications,but the restenosis rate of vertebral artery origin was 27. 1%. Conclusion Stent-assisted angioplasty has better clinical effect on severe VAOS,can effectively relieve the vascular stenosis,improve the neurological function,is with high safety,but the restenosis rate is high.%目的：比较药物疗法与支架成形术治疗重度椎动脉起始部狭窄（ VAOS ）的临床疗效。方法选择2012年1月—2014年1月在沧州市人民医院神经内科住院治疗的重度VAOS患者96例，采用随机数字表分为观察组和对照组，各48例。对照组患者采用药物疗法，观察组患者采用支架成形术。比较两组患者治疗前和出院后12个月血管狭窄率和NIHSS评分；比较两组患者出院后12个月血管闭塞、新发脑梗死和短暂性脑缺血发作（ TIA）发生率；并观察支架成形术治疗的安全性。结果治疗前两组患者血管狭窄率和 NIHSS 评分比较，差异无统计学意义（ P >0.05）；出院后12个月，观察组患者血管狭窄率、NIHSS评分及血管闭塞、新发脑梗死、TIA发生率均低于对照组（ P<0.05）。观察组患者手术成功率为97.9%，围术期均未出现严重并发症，出院后12个月椎动脉起始部再狭窄发生率为27.1%。结论支架成形术治疗重度VAOS的临床疗效优于药物疗法，能有效缓解患者血管狭窄、改善患者神经功能，安全性高，但术后再狭窄发生率较高。
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