国际脑血管病杂志
國際腦血管病雜誌
국제뇌혈관병잡지
INTERNATIONAL JOURNAL OF CEREBROVASCULAR DISEASES
2013年
4期
266-270
,共5页
刘高飞%李达文%朱敏%夏磊
劉高飛%李達文%硃敏%夏磊
류고비%리체문%주민%하뢰
颈动脉狭窄%血管成形术,气囊%支架%颈动脉窦%低血压%心动过缓%危险因素
頸動脈狹窄%血管成形術,氣囊%支架%頸動脈竇%低血壓%心動過緩%危險因素
경동맥협착%혈관성형술,기낭%지가%경동맥두%저혈압%심동과완%위험인소
Carotid Stenosis%Angioplasty,Balloon%Stents%Carotid Sinus%Hypotension%Bradycardia%Risk Factors
目的 探讨颈内动脉支架置入术(carotid artery stenting,CAS)时颈动脉窦反应(carotid sinus reaction,CSR)的危险因素.方法 回顾性收集36例行颈内动脉颅外段支架置入术的患者资料资料,并按是否发生CSR分为CSR组和无CSR组.采用单变量和多变量logistic回归分析术中发生CSR的危险因素.结果 36例患者中25例发生CSR(单纯低血压7例,单纯心动过缓4例,两者共存14例).CSR组年龄≥75岁(64.00%对27.27%;x2=2.384,P=0.028)、颈内动脉狭窄程度70%~99%(76.00%对36.36%;x2=4.430,P=0.035)、有症状狭窄(72.00%对36.36%;x2=4.082,P=0.043)、钙化斑块(76.00%对36.36%;x2 =4.430,P=0.035)、狭窄距分叉处距离≤10 mm(72.00%对27.27%;x2 =5.029,P=0.025)和球囊后扩(64.00%对18.18%;x2 =44.483,P=0.000)的患者构成比显著性高于无CSR组.多变量logistic回归显示,年龄≥75岁[优势比(odds ratio,OR) 1.520,95%可信区间(confidence interval,CI)1.376 ~4.369;P=0.034]、狭窄距分叉处距离≤10 mm(OR 2.432,95% CI2.423 ~3.421;P=0.041)和球囊后扩(OR 3.631,95% CI1.764~4.738;P=0.003)是CAS术中发生CSR的独立危险因素.结论 CSR是CAS术中的一种常见表现,高龄、狭窄距颈动脉分叉处距离≤10mm和球囊后扩是发生CSR的独立危险因素.
目的 探討頸內動脈支架置入術(carotid artery stenting,CAS)時頸動脈竇反應(carotid sinus reaction,CSR)的危險因素.方法 迴顧性收集36例行頸內動脈顱外段支架置入術的患者資料資料,併按是否髮生CSR分為CSR組和無CSR組.採用單變量和多變量logistic迴歸分析術中髮生CSR的危險因素.結果 36例患者中25例髮生CSR(單純低血壓7例,單純心動過緩4例,兩者共存14例).CSR組年齡≥75歲(64.00%對27.27%;x2=2.384,P=0.028)、頸內動脈狹窄程度70%~99%(76.00%對36.36%;x2=4.430,P=0.035)、有癥狀狹窄(72.00%對36.36%;x2=4.082,P=0.043)、鈣化斑塊(76.00%對36.36%;x2 =4.430,P=0.035)、狹窄距分扠處距離≤10 mm(72.00%對27.27%;x2 =5.029,P=0.025)和毬囊後擴(64.00%對18.18%;x2 =44.483,P=0.000)的患者構成比顯著性高于無CSR組.多變量logistic迴歸顯示,年齡≥75歲[優勢比(odds ratio,OR) 1.520,95%可信區間(confidence interval,CI)1.376 ~4.369;P=0.034]、狹窄距分扠處距離≤10 mm(OR 2.432,95% CI2.423 ~3.421;P=0.041)和毬囊後擴(OR 3.631,95% CI1.764~4.738;P=0.003)是CAS術中髮生CSR的獨立危險因素.結論 CSR是CAS術中的一種常見錶現,高齡、狹窄距頸動脈分扠處距離≤10mm和毬囊後擴是髮生CSR的獨立危險因素.
목적 탐토경내동맥지가치입술(carotid artery stenting,CAS)시경동맥두반응(carotid sinus reaction,CSR)적위험인소.방법 회고성수집36례행경내동맥로외단지가치입술적환자자료자료,병안시부발생CSR분위CSR조화무CSR조.채용단변량화다변량logistic회귀분석술중발생CSR적위험인소.결과 36례환자중25례발생CSR(단순저혈압7례,단순심동과완4례,량자공존14례).CSR조년령≥75세(64.00%대27.27%;x2=2.384,P=0.028)、경내동맥협착정도70%~99%(76.00%대36.36%;x2=4.430,P=0.035)、유증상협착(72.00%대36.36%;x2=4.082,P=0.043)、개화반괴(76.00%대36.36%;x2 =4.430,P=0.035)、협착거분차처거리≤10 mm(72.00%대27.27%;x2 =5.029,P=0.025)화구낭후확(64.00%대18.18%;x2 =44.483,P=0.000)적환자구성비현저성고우무CSR조.다변량logistic회귀현시,년령≥75세[우세비(odds ratio,OR) 1.520,95%가신구간(confidence interval,CI)1.376 ~4.369;P=0.034]、협착거분차처거리≤10 mm(OR 2.432,95% CI2.423 ~3.421;P=0.041)화구낭후확(OR 3.631,95% CI1.764~4.738;P=0.003)시CAS술중발생CSR적독립위험인소.결론 CSR시CAS술중적일충상견표현,고령、협착거경동맥분차처거리≤10mm화구낭후확시발생CSR적독립위험인소.
Objective To investigate the risk factors for carotid sinus reactions (CSR) during internal carotid artery stenting (CAS).Methods The clinical data of 36 patients treated with CAS were enrolled retrospectively.The patients were divided into either a CSR group or a non-CSR group according to whether they had CSR or not.The risk factors for CSR during procedure were analyzed using univariate and multivariate logistic regression analysis.Results Of the 36 patients,25 had CRS (7 simple hypotension,4 simple bradycardia,and 14 both co-existence).The constituent ratios of the patients of the age ≥ 75 years (64.00% vs.27.27% ;x2 =2.384,P =0.028),degree of CAS 70% to 99% (76.00% vs.36.36% ; x2 =4.430,P =0.035),symptomatic stenosis (72.00% vs.36.36% ; x2 =4.082,P =0.043),calcified plaque (76.00% vs.36.36% ;x2 =4.430,P =0.035),distance from stenosis to bifurcation ≤ 10 mm (72.00% vs.27.27% ;x2 =5.029,P =0.025) and balloon expansion (64.00% vs.18.18% ;x2 =44.483,P =0.000) in the CSR group were significantly higher than those in the non-CSR group.Multivariate logistic regression analysis showed that age ≥ 75 years (odds ratio [OR] 1.520,95% confidence interval [CI] 1.376-4.369; P =0.034),distance from stenosis to bifurcation ≤ 10 wm (OR 2.432,95% CI 2.423-3.421; P =0.041) and balloon expansion (OR 3.631,95% CI 1.764-4.738; P=0.003) were the independent risk factors for occurring CSR during CAS.Conclusions CSR is a common perforrance during CAS.Advanced age,distance from stenosis to bifurcation ≤ 10 mm and balloon expansion are the independent risk factors for occurring CSR.