颈动脉支架置入术后过度灌注综合征的危险因素分析

目的探讨颈动脉支架置入术(CAS)后发生过度灌注综合征(CHS)的危险因素。方法纳入419例患者的临床资料,其中48例同时行双侧CAS,共计行467次CAS。根据是否发生CHS分为CHS组15例和无CHS组404例。采用分层分析法分析术后发生CHS的危险因素。结果与无CHS组比较,CHS组糖尿病、术后高血压比例明显升高,差异有统计学意义(P<0.05,P<0.01)。单因素分析显示,术前糖尿病、术后高血压与CHS相关(P<0.05)。经分层分析显示,术前糖尿病(OR=3.168,95%CI:1.008～9.222,P=0.025)及术后高血压(OR=5.033,95%CI:1.733～14.646,P=0.001)为术后发生CHS的主要危险因素。结论 CAS术前糖尿病及术后伴高血压的患者更容易出现CHS。临床上对于术前有糖尿病史及术后出现高血压的CAS患者必须加以重视,尽早发现和处理CHS。

Risk factors for hyperperfusion syndrome following carotid artery stenting

Objective To study the risk factors for hyperperfusion syndrome following carotid artery stenting(CAS).Methods Clinical data about 419 patients who underwent 467 times of CAS(48 out of them underwent bilateral CAS) were retrospectively analyzed in this study.The patients were divided into hyperperfusion syndrome group(n=15) and non-hyperperfusion syndrome group(n=404) according to whether they were diagnosed with or without hyperperfusion syndrome.The risk factors for hyperperfusion syndrome after stenting were analyzed by stratified analysis.Results The incidence of diabetes mellitus(DM) and hypertension was significantly higher in hyperperfusion syndrome group than in non-hyperperfusion syndrome group after stenting(P<0.05,P<0.01).Univariate analysis showed that DM before stenting and hypertension after stenting were related with hyperperfusion syndrome(P<0.05).Stratified analysis showed that DM before stenting(OR=3.168,95%CI:1.008-9.222,P=0.025) and hypertension after stenting(OR=5.033,95%CI:1.733-14.646,P=0.001) were the independent risk factors for hyperperfusion syndrome after stenting.Conclusion Attention must be paid to patients with DM before stenting and hypertension after stenting since hyperperfusion syndrome is easy to occur in such patients,thus hyperperfusion syndrome should be diagnosed and treated as early as possibly.