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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 clinical factors related to restenosis after stent implantation in atherosclerosis-induced middle cerebral artery stenosis patients. Methods: The clinical data of 145 patients with middle cerebral artery stenosis underwent stenting were retrospectively analyzed. Digital subtraction angiography (DSA) and computed tomography angiography (CTA) were performed. Determine the rate of restenosis after stent implantation. The patients with restenosis were divided into restenosis group and non-restenosis group according to whether the follow-up patients had stenosis or not. The correlation between postoperative restenosis rate and age, gender, length of middle artery stenosis, stent placement and risk factors were analyzed. The statistical analysis of the significant difference of the restenosis rate between the relevant and non-related risk factors was carried out by chi-square test. Results: Of the 145 patients, 196 had middle cerebral artery stenosis with 164 scaffolds. The average preoperative stenosis rate was (82.3 ± 7.9)% and the average postoperative stenosis rate was (31.6 ± 4.9)%. Of the 121 patients who were followed up, 26 (21.49%) had restenosis. Univariate analysis showed no correlation between the length of disease, age, gender, alcohol intake and coronary heart disease and the rate of restenosis. The results of logistic multivariate analysis showed that smoking, diabetes, hypertension, hyperlipidemia and the type of stents were significantly correlated with restenosis after stenting, which was a risk factor for restenosis after stenting. Conclusions: Cerebral atherosclerosis leads to stenosis after stenting in patients with middle cerebral artery stenosis. It is related to smoking, diabetes, hypertension and other factors, controlling hypertension, diabetes and avoiding excessive smoking Reduce the risk of postoperative restenosis.