支架成形术治疗老年颈动脉狭窄效果及危险因素分析  

Stent angioplasty for carotid artery stenosis in the elderly: its curative effect and risk factor analysis

作　　者：姚晔[1] 王巍[2] 李琼[1] 张文龙[1] 王嵩[1] 

机构地区：[1]上海中医药大学附属龙华医院放射科,200032 [2]复旦大学附属华山医院放射科

出　　处：《介入放射学杂志》2016年第10期839-842,共4页Journal of Interventional Radiology

基　　金：上海市卫生计生委科研课题(20134169)

摘　　要：目的分析评价颈动脉支架成形术(CAS)治疗老年颈动脉狭窄的围手术期并发症、近中期疗效及危险因素。方法回顾性分析2011年6月至2014年6月收治的255例老年颈动脉狭窄患者临床资料,研究CAS术前危险因素(既往脑缺血史、高血压病史、吸烟史等)与围手术期并发症及近中期疗效的联系。结果术前所有患者改良Rankin量表(m RS)评分为平均(2.58±0.68)分,术后出院时66.7%患者(170/255)为平均(1.98±0.30)分(P<0.001),术后3个月78.8%患者(201/255)为平均(1.67±0.53)分(P<0.001),术后12个月98.8%患者(252/255)为平均(1.84±0.38)分(P<0.001)。术后出现脑梗死7例,短暂性脑缺血发作(TIA)8例,脑过度灌注综合征8例,既往脑梗死史、糖尿病且控制不佳、冠心病、未戒烟、高血压且控制不佳是危险因素;术后3个月发生TIA 13例,支架内再狭窄3例,既往脑梗死史及高脂血症是危险因素;术后12个月发生脑梗死10例,TIA 10例,支架内再狭窄5例,既往脑梗死史、吸烟史、高脂血症且控制不佳是危险因素。结论 CAS治疗老年颈动脉狭窄的有效性及安全性高,既往脑缺血史、高血压史及高脂血症是危险因素,术前需得到有效控制。Objective To investigate the perioperative complications, early and mid-term curative effect and risk factors of carotid artery stenting （CAS） in treating carotid stenosis in the elderly. Methods The clinical data of 255 aged patients with carotid stenosis, who were admitted to authors＇ hospital during the period from June 2011 to June 2014, were retrospectively analyzed. The correlations of the preoperative risk factors such as history of cerebral ischemia, history of hypertension, history of smoking, etc. with the perioperative complications and the mid-term curative effect were evaluated. Results The mean preoperative modified Rankin scale （mRS） score of all 255 patients was （2.58±0.68） points, which became （1.98±0.30） points in 66.7% of patients （170/255） at the time of discharge （P〈0.001）. Three months after operation the mean mRS score in 78.8% of patients （201/255） was （1.67±0.53） points （P〈0.001）. Twelve months after operation the mean mRS score in 98.8% of patients （252/255） was （1.84±0.38） points （P〈0.001）. After CAS, cerebral infarction occurred in 7 patients, transient ischemic attack （TIA） in 8 patients, and cerebral hyperperfusion syndrome in 8 patients; the history of cerebral infarction, poorly-controlled diabeies, coronary heart disease, smoking, poorly-controlled hypertension were the risk factors. Three months after CAS, TIA occurred in 13 patients and in-stent restenosis in 3 patients; the history of cerebral infarction and hyperlipemia were the risk factors. Twelve months after CAS, cerebral infarction occurred in 10 patients, TIA in 10 patients, and in-stent restenosis in 5 patients; the history of cerebral infarction, history of smoking, and poorly-controlled hypedipemia were the risk factors. Coneluslon For the treatment of carotid stenosis in the elderly, CAS is highly effective and safe. The history of hypertension, history of hypertension, and hyperlipemia are the risk factors, which need to be effectively controlled before

关 键 词：颈动脉狭窄 颈动脉支架成形术 老年 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]