颅内外血管狭窄支架置入术后再狭窄的相关因素研究  

A study on correlative factors of the restenosis post stent implantation of intracranial and extracranial arteries stenosis

作　　者：段春苗[1] 王铁军[1] 陈书阁[1] 石富铭[1] DUAN Chun-miao;WANG Tie-jun;CHEN Shu-ge(Neurology Department,Daxing Hospital Affiliated to Capital Medical University,Beijing,102600,China)

机构地区：[1]北京市大兴区人民医院神经内科,北京102600

出　　处：《中国医学装备》2018年第6期50-53,共4页China Medical Equipment

摘　　要：目的:探讨颅内外动脉狭窄支架置入术后再狭窄的相关因素。方法:回顾性分析142例颅内外动脉狭窄且行支架置入术患者的临床资料,经颈动脉彩超、经颅多普勒超声(TCD)、计算机断层扫描血管造影(CTA)和数字减影血管造影(DSA)检查,随访1年,根据是否出现支架内再狭窄分为再狭窄组和无再狭窄组,分析比较术后再狭窄与患者性别、年龄、支架直径及各危险因素的相关性,并进行Logistic回归确定其是否为危险因素。结果:在142例患者中共置入支架163枚,其中颈动脉支架72枚(占44.2%),椎动脉开口48枚(占29.4%),椎动脉颅内段11枚(占6.7%),锁骨下动脉近段27枚(占16.6%),基底动脉1枚(占0.6%),大脑中动脉M1段4枚(占2.4%);随访中,17例患者出现再狭窄(占12.0%),狭窄支架19枚(占11.7%)。单因素分析显示,吸烟、既往脑梗死、支架直径与再狭窄有相关性。Logistic多因素分析,吸烟、既往脑梗死、支架直径与支架置入术后再狭窄的相关性有统计学意义(OR=3.754,OR=3.411,OR=1.228;P<0.05)。结论:颅内外动脉狭窄支架置入术后再狭窄与吸烟、既往脑梗死和支架直径相关,是支架置入术后再狭窄的危险因素。Objective： To investigate the correlative factors of the restenosis post stent implantation of intracranial and extracranial arteries stenosis. Methods： The clinical documents of 142 patients with intracranial and extracranial arteries stenosis who were treated with stent implantation were researched by using retrospective analysis. All of them were followed up for one year by carotid color ultrasonography, transcranial Doppler（TCD） sonography, computed tomographic angiography（CTA） and digital subtraction angiography（DSA）. The patients were divided into restenosis group and normal group according to whether occurred restenosis in the stent. The correlations between postoperative restenosis and various risk factors, such as gender, age, diameter of stent, hypertension and others, were analyzed and compared, and Logistic regression was adopted to identify which was risk factor. Results： 163 stents were implanted in 142 patients and the number of carotid artery stents was 72（44.2%）, and the number of vertebral artery origin stents was 48（29.4%）, and the number of intracranial segment stents of vertebral artery was 11（6.7%）, and the number of proximal segment stents of subclavian artery was 27（16.6%）, the number of basilar artery stent was 1（0.6%）, and the number of cerebral middle artery M1 stents was 4（2.4%）. After one-year following up, 17 patients（12.0%） and 19 stents（11.7%） occurred restenosis. The results of single factor analysis indicated that smoking, cerebral infarction history and diameter of stent were correlative with restenosis, respectively. And Logistic regression suggested that smoking, cerebral infarction history and diameter of stent might be the risk factors of restenosis after stent was implanted, and their correlations were significant, respectively（OR=3.754, OR=3.411, OR=1.228, P〈0.05）. Conclusion： Intracranial and extracranial arteries restenosis after stent is implanted is closely correlative with smoking, cerebral infarction history a

关 键 词：颅内外动脉狭窄 支架置入术后 再狭窄 相关性因素 数字减影血管造影 

分 类 号：R651.12[医药卫生—外科学]