颈动脉狭窄血管结构特征与支架术后残余狭窄的相关性分析  

The correlation of carotid artery structure characteristics and residual stenosis after stenting

作　　者：陶昀璐[1] 华扬[1] 贾凌云[1] 王力力[1] 刘蓓蓓[1] 凌晨[1] 

机构地区：[1]首都医科大学宣武医院血管超声诊断科,北京100053

出　　处：《中华超声影像学杂志》2017年第6期490-493,共4页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金项目（81541121）

摘　　要：目的应用彩色多普勒超声（CDFI）分析颈动脉结构特征与颈动脉支架（CAS）置入后残余狭窄的发生率及其影响因素。方法回顾性分析2013年1月至2015年12月接受CAS置入术的596例患者（600枚支架）。术前1个月内及术后1周内行CDFI检查，分析残余狭窄的发生率及颈动脉病变管腔结构、动脉粥样硬化斑块特征与发生残余狭窄的相关性。结果不规则斑块（OR=9．02，95％CI：5．21-15．59，P〈0．05）、斑块表面钙化（OR=2．55，95％CI：1．45-4．49，P〈0．05）、术前狭窄处残余管径〈1．0mm（OR=1．61，95％CI：1．06-2．45，P〈0．05）显著增加了残余狭窄的风险度，是CAs术后残余狭窄的独立影响因素。结论依据颈动脉狭窄的血管结构特点选择CAS的治疗，尽可能降低残余狭窄的发生率，为提高远期疗效提供重要的临床价值。Objective To analyze the correlation of characteristics of carotid artery structure and the incidence of residual stenosis after carotid artery stent （CAS） placement and its influencing factors using color Doppler flow imaging （CDFI）. Methods Five hundred and ninety-six cases from January 2013 to December 2015 who underwent CAS （600 pieces of stent） were included in this study. All patients were examined by CDFI within 1 month before and 1 week after carotid artery stenting. The incidence of residual stenosis was analysed. The correlation of residual stenosis and the characteristics of carotid artery lesions and atheroselerotic plaque before stenting were analyzed respectively. Results There was positive correlation between the incidence rates of residual stenosis and irregularly shaped plaque （odd ratios, 9.02; 95% confidence interval, 5.21 - 15.59, P 〈0.05）, the plaques with calcification in the surface（odd ratios, 2.55 ;95% confidence interval, 1.45- 4.49, P d0.05）, the residual diameter of carotid stenosis less than 1.0 mm（odd ratios, 1.61 ; 95% confidence interval, 1.06 - 2.45, P 〈 0.05 ）, which were the independent risk factors for influencing residual stenosis after CAS. Conclusions Choosing a more adaptable stent based on the characteristics of carotid artery lesions and atherosclerotie plaque by CDFI before stenting may be useful for the patients to get best result of revaseularization. The rate of residual stenosis may be decreased.

关 键 词：超声检查 多普勒 彩色 颈动脉狭窄 血管结构特征 残余狭窄 危险因素 

分 类 号：R445.1[医药卫生—影像医学与核医学] R743.3[医药卫生—诊断学]