CAJ | 학술논문

目的探讨颈动脉支架植入术(CAS)继发持续性血流动力学损害的危险因素.方法选择行CAS患者61例.先采用单因素Logistic回归分析CAS继发持续性血流动力学损害的危险因素,再经非条件Logistic多因素回归分析并校正年龄和性别因素后,分析持续性血流动力学损害的独立危险因素.结果 61例患者术中、术后发生低血压25例、心动过缓25例,发生率均为41.0%.根据患者术中、术后的血压、心率状况及血流动力学损害持续时间,分为持续性血流动力学损害者20例,非持续性血流动力学损害者41例.单因素Logistic回归分析提示与持续性血流动力学损害有关的因素:症状性狭窄、重度狭窄、球囊后扩张、采用激光雕刻支架(P值均<0.05);非条件Logistic多因素回归分析,发现球囊后扩张、采用激光雕刻支架是持续性血流动力学损害的独立危险因素,OR值分别为5.046(95%CI.342～18.977,P=0.017)和4.142(95%CI1.151～14.902,P=0.030);症状性狭窄为持续性血流动力学损害的独立保护因素,OR值为0.264(95%CI0.073～0.964,P=0.044).结论 CAS继发持续性血流动力学损害为常见的并发症,行球囊后扩张、采用激光雕刻支架的CAS患者更易发生持续性血流动力学损害,而症状性狭窄为其保护性因素.
목적 탐토경동맥지가식입술(CAS)계발지속성혈류동역학손해적위험인소.방법 선택행CAS환자61례.선채용단인소Logistic회귀분석CAS계발지속성혈류동역학손해적위험인소,재경비조건Logistic다인소회귀분석병교정년령화성별인소후,분석지속성혈류동역학손해적독립위험인소.결과 61례환자술중、술후발생저혈압25례、심동과완25례,발생솔균위41.0%.근거환자술중、술후적혈압、심솔상황급혈류동역학손해지속시간,분위지속성혈류동역학손해자20례,비지속성혈류동역학손해자41례.단인소Logistic회귀분석제시여지속성혈류동역학손해유관적인소:증상성협착、중도협착、구낭후확장、채용격광조각지가(P치균<0.05);비조건Logistic다인소회귀분석,발현구낭후확장、채용격광조각지가시지속성혈류동역학손해적독립위험인소,OR치분별위5.046(95%CI.342～18.977,P=0.017)화4.142(95%CI1.151～14.902,P=0.030);증상성협착위지속성혈류동역학손해적독립보호인소,OR치위0.264(95%CI0.073～0.964,P=0.044).결론 CAS계발지속성혈류동역학손해위상견적병발증,행구낭후확장、채용격광조각지가적CAS환자경역발생지속성혈류동역학손해,이증상성협착위기보호성인소.
Objective To investigate the risk factors for persistent hemodynamic depression after carotid angioplasty and stenting(CAS). Methods Sixty-one patients with CAS were included. By univariate Logistic regression analysis,the influencing factors for persistent hemodynamic depression were analyzed,by stepwise Logistic regression analysis and adjustment for age and gender factors,the independent risk factors for persistent hemodynamic depression were analyzed. Results In 61 patients,25 cases had hypotension,25 cases had bradycardia,all for 41.0% incidence. According to the patients intraoperative and postoperative blood pressure,heart rate conditions,the duration of hemodynamic depression,the cases were divided into persistent hemodynamic depression group (20 cases) and no-persistent hemodynamic depression group(41 cases). Univariate Logistic regression analysis indicated that persistent hemodynamic depression influencing factors were the symptomatic stenosis, severe stenosis, using balloon dilatation, implantation of laser-carving stent(P<0.05). With adjustment for age and gender factors, stepwise Logistic regression analysis showed that using balloon dilatation, implantation of laser-carving stent were the independent risk factors for persistent hemodynamic depression (OR = 5.046,95%CI 1.342-18.977,P = 0.017;OR = 4.142,95%CI 1.151-14.902, P= 0.030),symptomatic stenosis was the independent protective factor for persistent hemodynamic depression (OR = 0.264,95% CI 0.073-0.964,P= 0.044). Conclusions Persistent hemodynamic depression after CAS is a common complication.CAS patients with using balloon dilatation, implantation of laser-carving stent are more susceptible to persistent hemodynamic depression, while symptomatic stenosis is its protective factor.