肾动脉型大动脉炎单纯球囊扩张术后再狭窄的影响因素分析  

Risk factors for restenosis of plain old balloon angioplasty therapy in patients with Takayasu′s arteritis involved renal artery

作　　者：刘一人[1] 佟铸[1] 郭建明[1] 谷涌泉[1] 郭连瑞[1] Liu Yiren;Tong Zhu;Guo Jianming;Gu Yongquan;Guo Lianrui(Department of Vascular Surgery,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院血管外科,北京100053

出　　处：《国际外科学杂志》2024年第3期170-174,共5页International Journal of Surgery

基　　金：国家重点研发计划项目(2021YFC2500504,2022YFC3602404)。

摘　　要：目的探讨单纯球囊扩张(POBA)治疗肾动脉型大动脉炎术后再狭窄的影响因素。方法分析2014年1月—2020年12月首都医科大学宣武医院收治的47例(47条血管)累及肾动脉的大动脉炎患者临床资料,其中男性12例,女性35例;年龄范围21~43岁,平均(28.52±10.78)岁。所有患者均采用POBA进行治疗,根据术后血管狭窄情况分为球囊扩张后再狭窄组(n=18)和无再狭窄组(n=29)。所有患者术后常规随访,术后1、3、6个月到门诊就诊并复查超声检查,6个月后患者每半年到门诊复查超声检查。随访36~108个月。比较两组临床基本资料、两组的支架长度,以及介入术后血管残余狭窄>20%的比例。正态分布的计量资料用均数±标准差(x±s)表示,组间比较采用t检验;计数资料采用例(%)表示,组间比较采用χ^(2)检验;应用多元Logistic回归模型分析球囊扩张后再狭窄的独立危险因素,并计算OR值及95%CI。结果所有患者施行球囊扩张手术均获得成功,两组基本资料具有可比性,随访中发现18例患者术后发生再狭窄,29例保持通常,一期通畅率为61.7%。通过Logistic多因素回归分析显示高密度脂蛋白(HDL-C)、病变长度是肾动脉型大动脉炎POBA术后再狭窄影响因素。与无再狭窄组比较,再狭窄组HDL-C水平较低,置入支架明显较长(P<0.05);介入术后血管残余狭窄>20%在再狭窄组中的比例高于无再下狭窄组(P>0.05)。结论血清HDL-C、支架长度可能是肾动脉型大动脉炎单纯球囊扩张术后再狭窄的独立影响因素。Objective To explore the predictors and reasons for restenosis in patients with Takayasu′s arteritis(TA)involved renal artery after plain old balloon angioplasty(POBA).Methods The clinical data of 47 TA patients(47)with renal artery admitted to Xuanwu Hospital,Capital Medical University from January 2014 to December 2020 were analyzed,including 12 man and 35 female.The age ranged from 21 to 43 years old,with an average of(28.52±10.78)years old.All patient were diagnosed as TA and underwent POBA.The patients were divided into restenosis group(n=18)and non-restenosis group(n=29).The patients were followed up at 1,3,and 6 months after surgery,and after 6 months,the patients were followed up every 6 months.All patients were followed up from 36 to 108 months.The basic clinical data of the two groups were compared,and the length of stent and residual stenosis were also compared.Measurement data were expressed as(x±s),and t-test was used for comparison between groups.Counting data were expressed as the number of cases and percentage,and comparison between groups was analyzed using the chi-square test.Multivariate Logistic regression model was used to analyze the independent risk factors of restenosis after balloon dilation,and the OR value and 95%confidence interval were calculated.Logistic regression model was used to analyze the independent risk factors for restenosis after balloon dilation.Results All patients received POBA and operation was successfully.Restenosis was found in 18 patients,and 29 patients remained normal during the follow-up.The primary patency rate was 61.7%.Multivariate Logistic regression analysis showed that HDL-C and lesion length were the influencing factors of restenosis after POBA in TA of renal artery.The serum HDL-C level was significantly lower and the lesion was significantly longer in restenosis group than in non-restenosis group(P<0.05).The proportion of residual stenosis>20%was higher in restenosis group than in non-restenosis group(P>0.05).Conclusion Serum HDL-C level,lesion lengt

关 键 词：大动脉炎 肾动脉 血管成形术 危险因素 

分 类 号：R654.3[医药卫生—外科学]