动脉粥样硬化相关大脑中动脉狭窄支架植入血管成形术后再狭窄发生情况及危险因素分析

目的 探讨动脉粥样硬化(atherosclerosis,AS)相关大脑中动脉(middle cerebral artery,MCA)狭窄支架植入血管成形术后再狭窄发生情况及危险因素分析。方法 本研究纳入对象为2013年2月-2017年2月于本院行支架植入血管成形术治疗的122例AS相关MCA狭窄患者,术后随访2年; 根据计算机断层扫描血管造影(CTA)以及数字减影血管造影(DSA)检查术后再狭窄发生情况,分别设为再狭窄组与正常组,调查疾病史、狭窄情况、支架植入等病历资料,进行单因素及多因素logistic回归分析。结果 122例AS相关MCA狭窄术后动脉再狭窄25例,再狭窄率20.49%; 2组吸烟史、合并高血压病、糖尿病、高脂血症、术前动脉狭窄程度、饮酒史、动脉狭窄Moil分型、年龄有明显差异(P<0.05); 2组病变血管长度、支架种类、性别无明显差异(P>0.05); 多因素logistic回归分析显示,吸烟史(OR=3.443,95%CI=1.125～11.254)、合并高血压病(OR=4.827,95%CI=1.432～16.763)、合并糖尿病(OR=3.644,95%CI=1.243～12.043)、合并高脂血症(OR=3.923,95%CI=1.443～13.652)、术前动脉狭窄程度>75%(OR=2.787,95%CI=1.032～9.691)是AS相关MCA狭窄支架植入血管成形术后再狭窄的独立危险因素。结论 AS相关MCA狭窄支架植入血管成形术后容易出现动脉再狭窄,吸烟史、合并高血压病、合并糖尿病、合并高脂血症、术前动脉狭窄程度>75%均会增加其复发风险。

The analysis of occurrence situation and risk factors of restenosis after atherosclerosis-related middle cerebral artery stenosis with stent implanted blood vessel angioplasty

ObjectiveTo analyze the occurrence situation and risk factors of restenosis after atherosclerosis(AS)related middle cerebral artery(MCA)stenosis with stent implanted blood vessel angioplasty.Methods A total of 122 patients with AS-related MCA stenosis who underwent stent implanted blood vessel angioplasty in our hospital from February 2013 to February 2016 were selected as the study subjects.The patients were followed up for 2 years.According to the postoperative restenosis situation detected by computed tomography angiography(CTA)and digital subtraction angiography(DSA),they were set as restenosis group and normal group.The univariate and multivariate logistic regression analysises were used to investigate medical records such as disease history,stenosis situation,and stent implantation in two groups.Results There were 25 cases with arterial restenosis in 122 cases of AS-related MCA stenosis with stent implanted blood vessel angioplasty,restenosis rate was 20.49%.The differences of smoking history,combined hypertension,diabetes,hyperlipidemia,preoperative arterial stenosis rate,drinking history,arterial stenosis,Moil classification,age were statistically significant(P<0.05).There were no significant differences in lesion length,stent type,and gender between the two groups(P>0.05).Multivariate logistic regression analysis showed that smoking history(OR=3.443,95%CI=1.125～11.254),hypertension(OR=4.827,95%CI= 1.432～16.763),and diabetes(OR=3.644,95%CI=1.243～12.043),combined with hyperlipidemia(OR=3.923,95% CI=1.443～13.652),preoperative arterial stenosis degree >75%(OR=2.787,95% CI=1.032～9.691)were independent risk factors for restenosis after AS-related MCA stenosis implanted blood vessel angioplasty.Conclusion AS-related MCA stenosis implanted blood vessel angioplasty was prone to arterial restenosis after angioplasty.Smoking history,hypertension,diabetes,hyperlipidemia,and preoperative arterial stenosis degree >75% increased the risk of recurrence.