TASC-ⅡC/D型下肢动脉粥样硬化闭塞症腔内介入治疗后再狭窄的影响因素分析  

Analysis of factors affecting restenosis after endoluminal interventional treatment for TASC-ⅡC/D lower extremity atherosclerosis obliterans

作　　者：陈绵朋 殷世武 潘升权[1] 曾凡祎 王思远 CHEN Mianpeng;YIN Shiwu;PAN Shengquan;ZEGN Fanyi;WANG Siyuan(Department of Interventional Vascular Pain,Hefei Hospital Affiliated to Anhui Medical University,the Second People’s Hospital of Hefei,Hefei 230011,China;the Fifth Clinical College of Medicine,Anhui Medical University,Hefei 230032,China)

机构地区：[1]安徽医科大学附属合肥医院合肥市第二人民医院介入血管疼痛科,安徽合肥230011 [2]安徽医科大学第五临床医学院,安徽合肥230032

出　　处：《实用放射学杂志》2024年第6期969-972,1014,共5页Journal of Practical Radiology

摘　　要：目的探讨血管腔内介入治疗泛大西洋学会联盟(TASC-Ⅱ)C型或D型动脉粥样硬化闭塞症(ASO)患者术后再狭窄的影响因素。方法纳入81例经血管腔内介入治疗ASO患者,术后连续随访2年,比较再狭窄组和非狭窄组治疗前后资料,通过统计分析,明确再狭窄的影响因素以及相关因素在术前预测术后再狭窄的价值。结果81例患者在介入治疗术后2年内再狭窄的发生率为40.74%。单因素分析结果显示,2组患者的踝肱指数(ABI)、年龄、性别、吸烟史、体质量指数(BMI)、手术方式、支架置入数量、病变长度、高脂血症、冠心病、糖尿病、高血压情况比较,差异均无统计学意义(P>0.05);血液生化指标中超敏C反应蛋白(hs-CRP)、纤维蛋白原、中性粒细胞-淋巴细胞比值(NLR)、同型半胱氨酸(Hcy)、胱抑素C(Cys C)水平比较,差异有统计学意义(P<0.05);二元logistic回归分析结果为纤维蛋白原水平、hs-CRP、NLR、Hcy、Cys C均是ASO术后再狭窄的独立危险因素[比值比(OR)=40.501、4.507、4.381、1.509、23.094,P<0.05];受试者工作特征(ROC)曲线分析结果显示hs-CRP、NLR、Cys C可有效预测ASO术后再狭窄,曲线下面积(AUC)分别为0.683、0.637、0.632,截断值分别为4.225、3.465、1.000(P<0.05)。结论ASO患者介入术后血管再狭窄与纤维蛋白原、hs-CRP、NLR、Hcy、Cys C水平相关,且hs-CRP、NLR、Cys C可作为预测ASO患者介入术后血管再狭窄的血液生化指标。Objective To investigate the affecting factors of postoperative restenosis in patients with Trans Atlantic Inter-Society Consensus-Ⅱ(TASC-Ⅱ)type C or D atherosclerosis obliterans(ASO)treated with endovascular intervention.Methods Eighty-one patients who underwent endovascular interventional treatment for ASO were included and were followed up continuously for two years after the procedure.Also,the pre-and post-treatment data of the restenosis group and the nonstenosis group were compared and statistically analyzed to clarify the affecting factors of restenosis as well as the value of the related factors in predicting the postoperative restenosis in the preoperative period.Results The incidence of restenosis in 81 patients was 40.74%within two years after the interventional treatment.The unifactorial results showed that the comparison of ankle brachial index(ABI),age,gender,smoking history,body mass index(BMI),procedure,number of stent placement,lesion length,hyperlipidemia,coronary heart disease,diabetes mellitus,and hypertension between the two groups was not statistically significant(P>0.05);the comparison of blood biochemical indexes in the levels of hypersensitive C-reactive protein(hs-CRP),fibrinogen,neutrophil-lymphocyte ratio(NLR),homocysteine(Hcy),and cystatin C(Cys C)showed a difference of statistically significant(P<0.05);binary logistic regression results for fibrinogen level,hs-CRP,NLR,Hcy,and Cys C were all independent risk factors for postoperative restenosis[odds ratio(OR)=40.501,4.507,4.381,1.509,and 23.094,P<0.05].The results of receiver operating characteristic(ROC)curves showed that hs-CRP,NLR,and Cys C could effectively predict ASO postoperative restenosis,with area under the curve(AUC)of 0.683,0.637,and 0.632,and cutoff values of 4.225,3.465,and 1.000,respectively(P<0.05).Conclusion Post-interventional vascular restenosis in ASO patients is correlated with the levels of fibrinogen,hs-CRP,NLR,Hcy,and Cys C.Also,hs-CRP,NLR,and Cys C may be used as blood biochemical indexes to predict post-i

关 键 词：下肢 动脉粥样硬化闭塞症 介入治疗 血管再狭窄 

分 类 号：R543.5[医药卫生—心血管疾病] R815[医药卫生—内科学]