影响下肢动脉硬化闭塞症腔内支架成形术后缺血症状复发的多因素分析  

Multivariate analysis of recurrence of ischemic symptoms after stenting for lower extremity arteriosclerotic occlusive diseases

作　　者：王磊[1] 任昊[2] 慈红波[2] 戈小虎[2] 

机构地区：[1]石河子大学医学院,新疆石河子832000 [2]新疆维吾尔自治区人民医院血管外科,乌鲁木齐830000

出　　处：《中国血管外科杂志（电子版）》2014年第4期226-229,251,共5页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的 探讨影响下肢动脉硬化闭塞症腔内支架成形术术后下肢缺血症状复发的相关因素。方法 回顾性分析2008年4月至2014年4月乌鲁木齐新疆维吾尔自治区人民医院收治的69例(共70条患肢)下肢动脉硬化闭塞症行腔内支架成形术术后下肢缺血症状复发患者的临床资料,采用寿命表法计算患者血管通畅率,用long-rank检验进行单因素分析,应用COX模型进行症状复发的多因素分析。结果 68例(69条患肢)患者获得随访,随访时间6~72个月。半年、1、3、5年通畅率分别为90%、71%、39%及31%。2例行踝以上截肢术,保肢率为97.1%。随访中死亡6例。术后22例症状复发。单因素分析表明:术后停用抗血小板聚集及降脂药物、功能锻炼对症状复发有影响(P【0.05)。多因素分析显示:术后停用抗血小板聚集及降脂药物是影响术后缺血症状复发的独立危险因素(P【0.05)。结论 是否长期坚持服用抗血小板药物和降脂药物是影响术后缺血症状复发的相关危险因素。腔内支架成形术术后良好的随访及依从性对症状复发可起到预防作用。Objective To investigate factors of recurrence of ischemic symptoms after endovascular stenting for lower extremity arteriosclerotic occlusion.Methods The data of 69 recurrent patients with lower extremity arteriosclerotic occlusive disease underwent endovascular stenting in our hospital from Apr.2008 to Apr.2014 were reviewed and analyzed by life table method, long-rank test and COX model.Results During the follow-up time(6~72 months), 68 cases(69 limbs)were followed up. And primary patency rate at 6-month, 1-, 2- and 3-year was 90%, 71%, 39% and 31%,respectively. Two cases underwent above-ankle amputation. Limb salvage rate was 97.1%. Six cases died and 22 cases recurred. Univariate analysis showed that recurrence was related to discontinuation of antiplatelet drugs and lipid-lowering drugs after operation,functional exercise(P<0.05). Multivariate analysis showed that postoperative antiplatelet and lipid-lowering drug withdrawal was an independent risk factor of recurrence of ischemic symptoms(P<0.05).Conclusion Whether to take antiplatelet drugs and lipid-lowering drugs for a long time postoperatively is a related risk factor of recurrence. Great follow-up and patient compliance can prevent recurrence after endovascular stenting for lower extremity arteriosclerotic occlusive diseases.

关 键 词：下肢动脉硬化闭塞症 球囊扩张 支架 危险因素 

分 类 号：R654.4[医药卫生—外科学]