颈动脉支架植入术术后发生残余狭窄的影响因素分析  

Analysis of influencing factors of residual stenosis after carotid artery stent implantation

作　　者：李润雄[1] LI Run-xiong(Department of Neurology,Dongguan People′s Hospital of Guangdong Province,Dongguan523059,China)

机构地区：[1]广东省东莞市人民医院神经内科,广东东莞523059

出　　处：《中国当代医药》2021年第3期98-101,105,共5页China Modern Medicine

基　　金：广东省东莞市社会科技发展项目(2016108101031)。

摘　　要：目的分析颈动脉支架植入术术后发生残余狭窄的影响因素。方法选取2016年2月~2019年2月在东莞市人民医院接受颈动脉支架植入术治疗的152例颈动脉狭窄患者(共173枚支架)的资料进行回顾性分析,于术前2周内行颈动脉超声造影及彩色多普勒血流显像技术(CDFI)检查,术后7 d内实施CDFI检查。依据患者颈动脉支架植入术术后是否发生残余狭窄,将其分为残余狭窄组(n=36)与非残余狭窄组(n=116)。统计颈动脉支架植入术术后残余狭窄的发生率;比较残余狭窄组与无残余狭窄组患者的临床资料、治疗效果;分析不同颈动脉狭窄结构特征对颈动脉支架植入术术后残余狭窄发生率的影响;采用多因素Logistic分析考察颈动脉支架植入术术后发生残余狭窄的危险因素。结果152例患者中,颈动脉支架术后残余狭窄的发生率为23.68%(36/152),植入支架50枚。残余狭窄组的高血压患病率为75.00%,高于无残余狭窄组的64.66%,差异有统计学意义(P<0.05)。残余狭窄组的治疗总有效率为97.22%,高于无残余狭窄组的81.90%,差异有统计学意义(P<0.05)。不同支架位置、回声等级情况、斑块钙化情况患者的颈动脉支架植入术术后残余狭窄发生率比较,差异无统计学意义(P>0.05)。术前血管内径<1.0 mm、不均质回声斑块、表面钙化斑块、不规则斑块、术前颈动脉超声造影分级高患者的颈动脉支架植入术术后残余狭窄发生率更高,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,高血压(β=0.38,OR=1.48,95%CI=0.90~2.38)、术前血管内径<1.0 mm(β=0.46,OR=1.60,95%CI=1.05~2.43)、表面钙化斑块(β=0.92,OR=2.54,95%CI=1.46~4.48)、不规则斑块(β=2.17,OR=9.01,95%CI=5.20~15.58)、术前颈动脉超声造影分级高(β=0.65,OR=1.24,95%CI=1.15~2.77)是颈动脉支架植入术后发生残余狭窄的危险因素(P<0.05)。结论颈动脉狭窄患者的血管结构特征(如术前血管内径、表面Objective To analyze the influencing factors of residual stenosis after carotid artery stent implantation.Methods Data of 152 patients with carotid artery stenosis(173 stents in total)who received carotid artery stent implantation in Dongguan People′s Hospital from February 2016 to February 2019 were retrospectively analyzed.Carotid angiography and color Doppler flow imaging(CDFI)were performed within 2 weeks before surgery,and CDFI was performed within 7 days after surgery.Patients were divided into residual stenosis group(n=36)and non-residual stenosis group(n=116)according to whether residual stenosis occurred after carotid artery stent implantation.The incidence of residual stenosis after carotid stenting was calculated.The clinical data and therapeutic effect of patients in residual stenosis group and non-residual stenosis group were compared.The influence of different structure characteristics of carotid artery stenosis on the incidence of residual stenosis after carotid stent implantation were analyzed.Multivariate Logistic analysis was used to investigate the risk factors for residual stenosis after carotid artery stenting.Results In 152 patients,the incidence of residual stenosis after carotid stenting was 23.68%(36/152),and 50 stents were inserted.The prevalence of hypertension in the residual stenosis group was 75.00%,higher than that in the non-residual stenosis group(64.66%),with a statistically significant difference(P<0.05).The total effective rate of the residual stenosis group was 97.22%,higher than that of the non-residual stenosis group(81.90%),and the difference was statistically significant(P<0.05).There were no statistically significant differences in the incidence rates of residual stenosis after carotid artery stent implantation among patients with different stent locations,echo levels,and plaque calcification(P>0.05).Patients with preoperative vascular diameter<1.0 mm,heterogeneous echogenic plaque,surface calcification plaque,irregular plaque,and high grade of preoperative carotid arte

关 键 词：颈动脉狭窄 血管结构特征 颈动脉支架植入术 术后残余狭窄 彩色多普勒血流显像技术 颈动脉超声造影 

分 类 号：R543.4[医药卫生—心血管疾病]