脑血管支架置入术后再狭窄的危险因素分析  

Risk factors for restenosis after cerebral vascular stent implantation

作　　者：梅育嘉[1] 罗杰峰[1] 许红玉 MEI Yujia;LUO Jiefeng;XU Hongyu(Department of Neurology, the Second Affiliated Hospital of Guangxi Medical University, Nanning 530007, China;Department of Neurology, Minzu Hospital of Guangxi Zhuang Autonomous Region, Nanning 530001,China)

机构地区：[1]广西医科大学第二附属医院神经内科,南宁市530007 [2]广西壮族自治区民族医院神经内科,南宁市530001

出　　处：《微创医学》2019年第3期280-283,297,共5页Journal of Minimally Invasive Medicine

基　　金：广西区卫计委自筹经费科研课题(编号:Z20170092)

摘　　要：目的 探讨脑动脉支架置入术后发生支架内再狭窄(ISR)的危险因素。方法 回顾性分析经数字减影血管造影(DSA)、CT血管造影(CTA)确诊的103例脑动脉重度狭窄患者的临床资料。出院后60个月内复查DSA、CTA,以支架内再狭窄为终点事件,术后发生再狭窄的34例患者为再狭窄组,未发生再狭窄的69例患者为对照组。对再狭窄原因行单因素及多因素COX生存分析。结果 单因素分析显示,两组平均血小板体积(MPV)、嗜烟酒、基底动脉比较(P<0.1),可能与再狭窄相关。两组年龄、性别、并发症、同型半胱氨酸水平(Hcy)、血小板(PLT)等指标比较,差异无统计学意义(P>0.05)。多因素COX生存分析,向前法LR显著相关因素为:基底动脉(P=0.043,HR=3.044)、MPV(P=0.045,HR=0.612);向后法LR显著相关因素为:基底动脉(P=0.015,HR=3.950)、性别(P=0.071,HR=0.465)、年龄(P=0.088,HR=1.033)、MPV(P=0.065,HR=0.624)。结论 女性、高龄、基底动脉支架是ISR的危险因素。长期MPV增大所反映的慢性血小板耗竭,是ISR的保护性因素。Objective To investigate the risk factors foRin-stent restenosis (ISR) afteRcerebral artery stenting. Methods The clinical data of1 03 patients with severe cerebral artery stenosis confirmed by digital subtraction angiography (DSA) and CT angiography (CTA) were retrospectively analyzed. The patients were reexamined by DSA and CTA within 60 months afteRdischarge. ISRserved as the end point. Thirty-fouRpatients with postoperative restenosis were enrolled in the restenosis group, while 69 patients without restenosis were enrolled in the control group. Univariate and multivariate Cox survival analysis of causes of restenosis were performed. Results Univariate analysis revealed that mean platelet volume (MPV), cigarette and drink abuse, and basilaRartery probably correlated with restenosis in the two groups( P <0.1). There were no statistically significant differences between the two groups in age, gender, complications, homocysteine(Hcy) level, oRplatelet(PLT)( P >0.05). Multivariate Cox survival analysis revealed that basilaRartery ( P =0.043, HR=3.044) and MPV ( P =0.045 , HR=0.612) were significant correlative factors foRforward Logistic regression method;basilaRartery ( P =0.015, HR=3.950), gendeR( P =0.071, HR=0.465), age ( P =0.088, HR=1.033 ), and MPV ( P =0.065, HR=0.624) were significant correlative factors foRbackward Logistic regression method. Conclusion Female, advanced age, and basilaRartery stenting are risk factors foRISR. Chronic platelet depletion reflected by long-term increase of MPV is a protective factoRfoRISR.

关 键 词：脑血管狭窄 支架置入术 再狭窄 危险因素 

分 类 号：R473[医药卫生—护理学]