颈动脉支架术后血流动力学相关因素分析  

Correlation factors for hemodynamics after carotid artery stenting

作　　者：齐立[1] 俸军林[1] 唐永刚[1] 谌艳芳[1] 焦力群[2] 李慎茂[2] 

机构地区：[1]桂林医学院附属医院神经内科,广西桂林541001 [2]首都医科大学宣武医院介入中心,北京100053

出　　处：《中风与神经疾病杂志》2012年第1期46-48,共3页Journal of Apoplexy and Nervous Diseases

基　　金：广西科学研究与技术开发计划项目(NO.桂科攻10124001B-16)

摘　　要：目的探讨颈内动脉狭窄支架置入术后影响血流动力学的相关因素。方法颈内动脉狭窄经过颈动脉支架成形术治疗的患者中术后出现血流动力学改变32例和35例未出现血流动力学改变的患者的临床资料进行分析:血流动力学改变与患者年龄、高血压、糖尿病、狭窄程度、球囊型号、支架的型号、病变靠近颈动脉球部及球囊扩张次数相关性。结果结果提示狭窄程度(B=0.536;P=0.024;OR=2.591)、高血压(B=-1.654;P=0.006;OR=0.131)、球囊型号(B=1.818;P=0.012:OR=0.133)和支架的型号(B=1.328;P=0.021;OR=2.29)、病变位于球部(B=1.613;P=0.014:OR=0.133)和球囊扩张的次数(B=1.328;P=0.022;OR=2.39)与血流动力学改变密切相关。结论颈动脉支架置入术后继发的颈动脉窦反射引起血流动力学损害是常见的并发症,其血压、狭窄的程度、病变位于球部、球囊的型号、支架的型号及球囊扩张次数这些因素将会直接影响术后患者血流动力学的变化。Objective To investigate the correlation factors for hemodynamics after carotid artery angioplasty and stenting（CAS）.Methods Two groups were followed.Thirty-five patients with carotid artery stenosis were treated with stent implantation.This group showed normal hemodynamics.The other group included thirty-two patientswith hemodynamic changes.The hemodynamic factors were analyzed retrospectively,including hypertension,diabetes mellitus,degree of stenosis,size of balloon,size of stent,location of atherosclerotic plaque and times of balloon dilatation.Results Logistic regression suggested that degree of stenosis（B=0.536;P=0.024;OR=2.591）,hypertension（B=-1.654;P=0.006;OR=0.131）,size of balloon,（B=1.818;P=0.012：OR=0.133）,size of stent（B=1.328;P=0.021;OR=2.29）,location of atherosclerotic plaque（B=1.613;P=0.014：OR=0.133）and times of balloon dilatation were closely correlated with hemodynamics.Conclusions Hemodynamic depression caused by carotid sinus following CAS is a common complication.hypertension,degree of stenosis,size of balloon,size of stent,location of atherosclerotic plaque and times of balloon dilatation are the independent correlation factors for hemodynamics.

关 键 词：颈动脉支架 血流动力学改变 血压 心率 相关因素 

分 类 号：R743[医药卫生—神经病学与精神病学]