目的 探讨颅内动脉瘤分别应用Atlas与LVIS Jr支架对患者神经功能、脑血流灌注情况的影响。 方法 收集2023年8月至2024年8月于张家口市第一医院接受治疗的颅内动脉瘤患者128例作为研究对象，依据治疗方法分为LVIS Jr支架组（65例，随访12个月后失访4例，最终纳入61例）、Atlas支架组（63例，随访12个月后失访2例，最终纳入61例），两组均随访至术后12个月。比较两组术中器械性能指标及不良事件，美国国立卫生院脑卒中量表（NIHSS）评分、简易精神状态评价量表（MMSE）评分（术前、术后24 h、术后7 d），Raymond分级（术后即刻），格拉斯哥预后评分（GOS）、复发情况（随访12个月后），血清肿瘤坏死因子-α（TNF-α）、C反应蛋白（CRP）、神经生长因子（NGF）、脑源性神经营养因子（BDNF）水平（术前、术后3 d），脑血流灌注情况（术前、术后6个月），并发症发生情况（研究期间）。 结果 Atlas支架组一次到位成功率、贴壁良好率高于LVIS Jr支架组（P < 0.05），两组支撑满意率及术中不良事件总发生率比较，差异无统计学意义（P > 0.05）。术前~术后7 d两组NIHSS评分均逐渐降低，Atlas支架组均更低（P < 0.05）。术前至术后7 d两组MMSE评分均逐渐升高，Atlas支架组均更高（P < 0.05）。术后即刻，Atlas支架组患者Raymond分级Ⅰ级的患者占比高于LVIS Jr支架组（P < 0.05）。随访12个月后，两组GOS评分组间比较，差异无统计学意义（P > 0.05）。与术前比较，术后3 d两组血清TNF-α、CRP、NGF、BDNF水平均升高，Atlas支架组血清TNF-α、CRP水平低于LVIS Jr支架组，血清NGF、BDNF水平则高于LVIS Jr支架组（P < 0.05）。与术前比较，术后6个月两组局部脑血容量（rCBV）均升高，Atlas支架组更高，颅内压（ICP）则降低，Atlas支架组更低（P < 0.05）。研究期间，两组并发症总发生率组间比较，差异无统计学意义（P > 0.05），随访12个月后，Atlas支架组复发率低于LVIS Jr支架组（P < 0.05）。 结论 相较于LVIS Jr支架，Atlas支架在颅内动脉瘤治疗中具有更优的术中到位性能及贴壁性能，可提高栓塞效果，改善脑血流灌注情况，调节血清TNF-α、CRP、NGF、BDNF水平，促进患者认知功能及神经功能恢复，降低复发率；两组在支撑性能、术中不良事件、远期预后及并发症发生风险方面相当。

Objective To investigate the impacts of Atlas and LVIS Jr stents on the neurological function and cerebral blood perfusion in patients with intracranial aneurysms. Methods One hundred and twenty-eight patients with intracranial aneurysms who received treatment at our hospital from August 2023 to August 2024 were selected as the research subjects. Based on the treatment methods， they were divided into the LVIS Jr stent group （65 cases； 4 cases were lost to follow-up after 12 months， and 61 cases were finally included） and the Atlas stent group （63 cases； 2 cases were lost to follow-up after 12 months， and 61 cases were finally included）. Both groups were followed up until 12 months after the operation. A comparison was made between the two groups in terms of intraoperative instrument performance indicators and adverse events， scores of the NIH Stroke Scale （NIHSS）， scores of the Mini - Mental State Examination （MMSE） （pre-operative， 24 h post-operative， and 7 d post-operative）， Raymond classification （immediately post-operative）， Glasgow Outcome Scale （GOS）， recurrence rates （after 12 months of follow-up）， serum levels of tumor necrosis factor-alpha （TNF-α）， C-reactive protein （CRP）， nerve growth factor （NGF）， and brain-derived neurotrophic factor （BDNF） （pre - operative and 3 d post-operative）， cerebral blood perfusion （pre-operative and 6 months post-operative）， and complication incidence （during the study period）. Results The one-time success rate and good adherence rate of the Atlas stent group were higher than those of the LVIS Jr stent group （P < 0.05）. However， there was no significant difference in the support satisfaction rate and the total incidence of adverse events between the two groups （P > 0.05）. The NIHSS scores in both groups gradually decreased from pre-operative to 7 days after the operation， and the scores in the Atlas stent group were even lower （P < 0.05）. The MMSE scores in both groups gradually increased from pre-operative to 7 days post - operation， particularly in the Atlas stent group （P < 0.05）. Immediately after the operation， the proportion of patients with Raymond Grade Ⅰ in the Atlas stent group was higher than that in the LVIS Jr stent group （P < 0.05）. After 12 months of follow-up， there was no significant difference in the GOS scores between the two groups （P > 0.05）. Compared with the pre-operative levels， the serum levels of TNF-α， CRP， NGF， and BDNF in both groups increased 3 days after the operation. The serum levels of TNF-α and CRP in the Atlas stent group were lower than those in the LVIS Jr stent group， while the serum levels of NGF and BDNF were higher than those in the LVIS Jr stent group （P < 0.05）. Compared with the pre-operative state， the regional cerebral blood volume （rCBV） increased in both groups 6 months after the operation， with a higher value in the Atlas stent group and a lower value in the ICP group （P < 0.05）. During the study period， there was no significant difference in the total incidence of complications between the two groups （P > 0.05）. After 12 months of follow-up， the recurrence rate of the Atlas stent group was lower than that of the LVIS Jr stent group （P < 0.05）. Conclusions Compared with the LVIS Jr stent， the Atlas stent demonstrated superior intraoperative positioning performance and adherent performance during the treatment of intracranial aneurysms. This could enhance the embolization effect， improve cerebral blood flow perfusion， regulate the levels of serum TNF-α， CRP， NGF， and BDNF， promote the recovery of cognitive function and neurological function， and reduce the recurrence rate. In terms of support performance， intraoperative adverse events， long-term prognosis， and risk of complications， the two groups were comparable.