摘要
目的:探讨动脉粥样硬化导致的大脑中动脉狭窄患者支架置入术后再狭窄的相关临床因素。方法:回顾性分析145例大脑中动脉狭窄并且行支架置入术患者的临床资料,以数字减影血管造影(digital subtraction angiography,DSA)和计算机断层扫描血管造影(computed tomographic angiography,CTA)等检查判断支架植入术后再狭窄率。根据随访患者是否出现动脉狭窄分为再狭窄组和无再狭窄组,分析比较术后再狭窄率与患者年龄、性别、中动脉狭窄长度、置入支架种类及各危险疾病因素的相关性。对有、无相关危险因素再狭窄率的差异显著性采用卡方检验进行统计分析。结果:145例患者有196处大脑中动脉狭窄,置入支架164枚。术前平均狭窄率为(82.3±7.9)%,术后平均狭窄率降为(31.6±4.9)%。随访121例患者中,26例(21.49%)出现再狭窄。单因素分析显示,病变长度、年龄、性别、饮酒和冠心病情况与再狭窄率无相关性。logistic多因素分析结果表明,吸烟、糖尿病、高血压、高血脂及置入支架种类与支架置入术后再狭窄的相关性有统计学意义,是置入术后再狭窄的危险因素。结论:脑动脉粥样硬化导致大脑中动脉狭窄患者支架置入术后再狭窄与置入支架类型有关,并与吸烟、糖尿病、高血压等因素有关,控制高血压、糖尿病,避免过度吸烟等能降低术后再狭窄的风险。
Objective：To investigate the influencing factors of re-stenosis in cerebral atherosclerosis patients with symptomatic middle cerebral artery stenosis after stenting. Methods：The clinical data of 145 patients with symptomatic middle cerebral artery（MCA）,stenosis underwent stenting were analyzed retrospectively.The restenosis rate after stenting was followed-up with transcranial Doppler（TCD）and digital subtraction angiography（DSA）. Follow-up examination was performed on 121 patients with stenting and then all patients were divided into artery stenosis and normoal groups. The length of MCA stenosis,type of stent,risk factors and their correlations with restenosis were analyzed. The significant differences of the restenosis rate with and without related risk factors were examined by chi-square test. Results：There were 196 stenosis among the 145 patients,and 164 stents were placed in these patients. The mean stenosis rate of the MCAs before the procedure was（82.3±7.9）%,and immediately after the procedure was（31.6±4.9）%. Twentysix patients（26/121,21.49%）had re-stenosis of less than 50%. Univariate analysis showed that there was no correlation between lesion length,age,sex,drinking,coronary heart diseases and restenosis rate. Logistic regression analysis showed that the correlation among type of stent,smoking,diabetes,hypertension and stent restenosis was statistically significant;they were independent risk factors.Conclusion：Re-stenosis in cerebral atherosclerosis patients with symptomatic middle cerebral artery stenosis after stenting is correlated with stent types,smoking and diabetes. Controlling hypertension,diabetes mellitus and avoiding excessive smoking can reduce the risk of restenosis after operation.
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2016年第1期69-72,共4页
Journal of Chongqing Medical University
关键词
大脑中动脉狭窄
支架置入术
再狭窄
相关性因素
middle cerebral artery stenosis
stent implantation
restenosis
correlation factors
