颈内动脉狭窄支架置入术后支架内再狭窄的相关危险因素分析

目的分析颈内动脉分叉处狭窄支架置入术(CAS)后支架内再狭窄的发生情况及相关因素,为临床预防CAS术后支架内再狭窄提供参考。方法分析行颈内动脉分叉处狭窄支架置入术的174例患者的病例资料,按原始治疗部位复发狭窄程度>50%为再狭窄,将病例分成再狭窄组(13例)和无再狭窄组(161例)。分析两组患者的性别、血压、高脂血症、血糖、是否吸烟、术后抗聚抗凝药物应用依从性与再狭窄的关系;t检验分析年龄、术前狭窄程度与再狭窄的关系。结果单因素分析显示:高龄、高血压、高血糖、高脂血症、吸烟、术后抗聚抗凝药物应用依从性差、术前狭窄率高、多个危险因素是CAS后支架内再狭窄的影响因素;Logistic回归分析显示:吸烟、高血压、高血糖、高脂血症是CAS后支架内再狭窄的独立危险因素。结论吸烟、高血压、高血糖、高脂血症是颈内动脉狭窄支架术后再狭窄的独立危险因素。

Analysis on relative factors of in-Stent restenosis after carotid angioplasty stenting

Objective To study and research the relative factors of in-stent restenosis after carotid angioplasty stenting and to supply theory base for preventing in-stent restenosis after carotid angioplasty stenting. Methods 174 patients who were implanted carotid angioplasty stenting in our hospital from April 2004 to May 2012 were selected in our study. More than 50% of stenosis in the original sites after treatment was restenosis. Patients were divided into restenosis group（ 13 patients） and none-restenusis group （161 patients）. We gathered the data as age, gender, diabetes, blood pressure, lipidemia, smoking, narrow extent of main artery, whether persisting in taking antiplateletlet and anticoagulation drugs between two groups and then analyzed the data. Results Single factor analysis showed senility, diabetes, hyperlipidemia, high blood pressure, smoking, never taking antiplateletlet and anticoagulation drugs, and high ratio of narrow extent of carotid stenosis before surgery were the effective factors of in-stent restenosis. Multivariate stepwise logistic regression analysis indicated smoking, high blood pressure, diabetes, and hyperlipidemia were the risk factors of in-stent restenosis. Conclusion Smoking, high blood pressure, diabetes, and hyperlipidemia are the risk factors of in-stent restenosis.