股动脉内膜剥脱治疗股总动脉硬化闭塞症后再狭窄影响因素的Cox比例风险回归分析  

Cox proportional hazard model for influencing factors of restenosis after femoral endarterectomy in treatment of arteriosclerosis obliterans at femoral artery

作　　者：李立强 谷涌泉 佟铸 张建 李建新 郭连瑞 崔世军 齐立行 

机构地区：[1]首都医科大学宣武医院血管外科首都医科大学血管外科学系,北京100053

出　　处：《中国普外基础与临床杂志》2017年第9期1071-1075,共5页Chinese Journal of Bases and Clinics In General Surgery

基　　金：北京市科技计划项目(项目编号:Z141107002514063);北京市医院管理局"登峰"人才计划(项目编号:DFL20150801)

摘　　要：目的探讨股动脉内膜剥脱术治疗股总动脉硬化闭塞症后发生再狭窄的相关影响因素。方法回顾性收集2012年1月至2017年1月期间于笔者所在医院行股动脉内膜剥脱术的103例股总动脉硬化闭塞症患者的临床资料,比较通畅组和再狭窄组患者的临床资料,并采用Cox比例风险回归模型探索股动脉内膜剥脱术后发生再狭窄的影响因素。结果 103例患者术后发生再狭窄36例(35.0%)。再狭窄组和通畅组患者的合并糖尿病情况、吸烟情况及低密度脂蛋白水平比较差异均有统计学意义(P<0.05),与通畅组比较,再狭窄组患者合并糖尿病的比例高,吸烟率高,低密度脂蛋白水平高。Cox比例风险回归模型结果表明:合并糖尿病[RR=3.338,95%CI为(1.003,11.113),P=0.049]和低密度脂蛋白水平[RR=3.311,95%CI为(1.166,9.397),P=0.024]均是股动脉内膜剥脱术后再狭窄的危险因素。结论对接受了股动脉内膜剥脱术的股总动脉硬化闭塞症患者,需严格控制血糖和强化他汀治疗,以降低股动脉内膜剥脱术后再狭窄的发生风险。Objective To investigate the influencing factors for restenosis after femoral endarterectomy in treatment of arteriosclerosis obliterans at femoral artery. Methods A total of 103 patients with arteriosclerosis obliterans at femoral artery who underwent femoral endarterectomy from Jan. 2012 to Jan. 2017 in our hospital were retrospectively selected as subjects of this study, to compare the clinical feathers between restenosis group and patent group, and then exploring the influencing factors for restenosis after femoral endarterectomy. Results Thirty-six patients （35.0%） suffered from restenosis after femoral endarterectomy. Patients in the restenosis group had a high proportion of high smoking and diabetes mellitus, and high level of low density lipoprotein than those corresponding indexes of the patent group （P〈0.05）. Results of Cox proportional hazard model showed that, diabetes meUitus （RR=3.338, 95% CI was （1.003, 11.113）, P=0.049） and high level of low density lipoprotein （RR=3.311, 95% CI was （1.166, 9.397）, P=0.024） were independent risk factors for restenosis after femoral endarterectomy. Conclusions Monitoring of high-risk factors like controlling blood glucose strictly and strengthening statin treatment should be done to reduce the risk of restenosis after femoral endarterectomy for patients with arteriosclerosis obliterans at femoral artery.

关 键 词：硬化闭塞症 股总动脉 股动脉内膜剥脱术 再狭窄 影响因素 

分 类 号：R654.4[医药卫生—外科学]