下肢动脉硬化闭塞症患者球囊联合支架植入术后发生再狭窄的影响因素及其预测价值分析  

Analysis of the influencing factors and predictive value of restenosis after balloon combined stent implantation in patients with lower extremity arteriosclerosis obliterans

作　　者：闫卓卓 王文辉[1] 常耀文[1] 刘声野[1] 陈国华[1] Yan Zhuozhuo;Wang Wenhui;Chang Yaowen;Liu Shengye;Chen Guohua(Department of Intervention,the First Hospital of Lanzhou University,Lanzhou 730000,Gansu,China)

机构地区：[1]兰州大学第一医院介入医学科,甘肃兰州730000

出　　处：《血管与腔内血管外科杂志》2025年第2期161-165,185,共6页Journal of Vascular and Endovascular Surgery

基　　金：甘肃省科学技术厅自然科学基金项目(22JR11RA036)。

摘　　要：目的探讨下肢动脉硬化闭塞症(ASO)患者球囊联合支架植入术后发生再狭窄的影响因素及其预测价值分析。方法收集2018年6月至2022年12月于兰州大学第一医院行球囊联合支架植入的81例ASO患者的临床资料,按照术后6个月下肢动脉情况将患者分为复发组(n=18)和通畅组(n=63)。比较两组患者的临床特征、影像学指标和实验室检查指标。采用二元Logistic回归模型分析ASO患者术后发生再狭窄或闭塞的危险因素。采用受试者工作特征(ROC)曲线分析腹主动脉钙化(AAC)-8评分、C反应蛋白与白蛋白比值(CAR)对ASO患者术后发生再狭窄或闭塞的预测效能,计算ROC曲线下面积(AUC)。结果AAC-8评分升高、CAR升高均是ASO患者球囊扩张成形术联合支架植入术后发生下肢动脉再狭窄或闭塞的危险因素(P﹤0.05)。ROC曲线显示,AAC-8评分预测ASO患者球囊联合支架植入术后发生下肢动脉再狭窄或闭塞的AUC为0.784,cut-off值为5.5分,灵敏度为77.8%,特异度为79.4%;CAR预测ASO患者球囊联合支架植入术后发生下肢动脉再狭窄或闭塞的AUC为0.758,cut-off值为0.872,灵敏度为66.7%,特异度为81.0%。结论AAC-8评分和CAR升高均是球囊联合支架植入术后发生下肢动脉再狭窄或闭塞的相关因素,均为易于得到的临床指标。Objective To investigate the influential factors and predictive value of restenosis in patients with lower extremity arteriosclerosis obliterans(ASO)after balloon combined with stent implantation.Method The clinical data of 81 ASO patients who underwent balloon combined stent implantation in the First Hospital of Lanzhou University from June 2018 to December 2022 were collected.According to the condition of lower extremity arteries 6 months after surgery,the patients were divided into relapse group(n=18)and patency group(n=63).The clinical features,imaging indexes and laboratory examination indexes of the two groups were compared.The risk factors of postoperative restenosis or occlusion in ASO patients were analyzed by binary Logistic regression model.The predictive efficacy of abdominal aortic calcification(AAC)-8 score and C-reactive protein to albumin ratio(CAR)in postoperative restenosis or occlusion of ASO patients was analyzed by receiver operating characteristic(ROC)curve,and the area under curve(AUC)was calculated.Result Increased AAC-8 score and increased CAR score were risk factors for restenosis or occlusion of lower extremity arteries after balloon dilatation combined with stenting in ASO patients(P<0.05).ROC curve showed that AAC-8 score predicted lower extremity artery restenosis or occlusion after balloon stenting in ASO patients of AUC was 0.784,the cut-off value was 5.5 scores,the sensitivity was 77.8%,the specificity was 79.4%.CAR predicted the AUC of lower extremity artery restenosis or occlusion after balloon stenting in ASO patients was 0.758,the cut-off value was 0.872,the sensitivity was 66.7%,and the specificity was 81.0%.Conclusion Both AAC-8 score and CAR elevation are related factors for restenosis or occlusion of lower extremity artery after balloon stenting,and are easy to obtain clinical indicators.

关 键 词：下肢动脉硬化闭塞症 C反应蛋白 腹主动脉钙化评分 预测 

分 类 号：R543[医药卫生—心血管疾病]