中华放射学杂志
中華放射學雜誌
중화방사학잡지
Chinese Journal of Radiology
2013年
1期
73-76
,共4页
椎动脉%支架%再狭窄%影响因素
椎動脈%支架%再狹窄%影響因素
추동맥%지가%재협착%영향인소
Vertebral artery%Stent%In-stent restenosis%Risk factors
目的 分析椎动脉起始部支架置入术后再狭窄的发生及影响因素并探讨其规律.方法 回顾性分析行椎动脉起始部支架置入术的144例患者的病例资料,按照原治疗部位复发狭窄程度＞50％定义为再狭窄,将病例分成再狭窄组(39例)和未狭窄组(105例).采用x2检验分析患者性别、年龄及高血压、糖尿病、冠心病、高脂血症病史,吸烟、饮酒情况,术前后循环供血不足症状、合并其他血管狭窄、置入支架类型及规格与再狭窄的关系,然后行Logistic回归得出结果.结果 144例中,椎动脉起始部支架置入术后再狭窄39例(26.4％),均发生在术后5个月内.x2检验示:未狭窄组和再狭窄组在性别(男89和34例,女16和5例；x2=0.804,p=0.370)、年龄(≥60岁60和21例；x2=2.358,P=0.125)、高血压(67和28例；x2=0.253,P=0.615)、糖尿病(27和9例；x2=0.914,P=0.91)、冠心病(32和6例；x2 =2.489,P=0.115)、高脂血症(6和5例；x2=0.478,p=0.489)、吸烟(50和24例；x2=0.129,P=0.719)、饮酒(20和13例；x2 =0.001,P=0.978)、置入支架直径(≥4 mm 53和18例；x2=0.213,P=0.645)及支架长度(≥15 mm 45和19例；x2=0.927,P=0.336)、手术前后循环供血不足症状(93和29例；x2=0.250,P=0.617)上差异无统计学意义(P＞0.05)；未狭窄组和再狭窄组在合并对侧椎动脉狭窄(43和24例；x2 =4.844,P=0.028)、合并颈内动脉狭窄(49和26例；x2=4.558,P=0.033)、支架类型(药物支架59和11例；x2=8.916,P=0.003)上差异有统计学意义(P＜0.05).进行Logistic回归分析显示:使用裸支架和合并颈内动脉狭窄为再狭窄的独立危险因素.结论 椎动脉起始部支架置入术后再狭窄多发生于支架置入术后5个月内.合并颈内动脉狭窄和使用裸支架会增加术后再狭窄,术前后循环症状为主和合并对侧椎动脉起始部狭窄可能会增加再狭窄.
目的 分析椎動脈起始部支架置入術後再狹窄的髮生及影響因素併探討其規律.方法 迴顧性分析行椎動脈起始部支架置入術的144例患者的病例資料,按照原治療部位複髮狹窄程度＞50％定義為再狹窄,將病例分成再狹窄組(39例)和未狹窄組(105例).採用x2檢驗分析患者性彆、年齡及高血壓、糖尿病、冠心病、高脂血癥病史,吸煙、飲酒情況,術前後循環供血不足癥狀、閤併其他血管狹窄、置入支架類型及規格與再狹窄的關繫,然後行Logistic迴歸得齣結果.結果 144例中,椎動脈起始部支架置入術後再狹窄39例(26.4％),均髮生在術後5箇月內.x2檢驗示:未狹窄組和再狹窄組在性彆(男89和34例,女16和5例；x2=0.804,p=0.370)、年齡(≥60歲60和21例；x2=2.358,P=0.125)、高血壓(67和28例；x2=0.253,P=0.615)、糖尿病(27和9例；x2=0.914,P=0.91)、冠心病(32和6例；x2 =2.489,P=0.115)、高脂血癥(6和5例；x2=0.478,p=0.489)、吸煙(50和24例；x2=0.129,P=0.719)、飲酒(20和13例；x2 =0.001,P=0.978)、置入支架直徑(≥4 mm 53和18例；x2=0.213,P=0.645)及支架長度(≥15 mm 45和19例；x2=0.927,P=0.336)、手術前後循環供血不足癥狀(93和29例；x2=0.250,P=0.617)上差異無統計學意義(P＞0.05)；未狹窄組和再狹窄組在閤併對側椎動脈狹窄(43和24例；x2 =4.844,P=0.028)、閤併頸內動脈狹窄(49和26例；x2=4.558,P=0.033)、支架類型(藥物支架59和11例；x2=8.916,P=0.003)上差異有統計學意義(P＜0.05).進行Logistic迴歸分析顯示:使用裸支架和閤併頸內動脈狹窄為再狹窄的獨立危險因素.結論 椎動脈起始部支架置入術後再狹窄多髮生于支架置入術後5箇月內.閤併頸內動脈狹窄和使用裸支架會增加術後再狹窄,術前後循環癥狀為主和閤併對側椎動脈起始部狹窄可能會增加再狹窄.
목적 분석추동맥기시부지가치입술후재협착적발생급영향인소병탐토기규률.방법 회고성분석행추동맥기시부지가치입술적144례환자적병례자료,안조원치료부위복발협착정도＞50％정의위재협착,장병례분성재협착조(39례)화미협착조(105례).채용x2검험분석환자성별、년령급고혈압、당뇨병、관심병、고지혈증병사,흡연、음주정황,술전후순배공혈불족증상、합병기타혈관협착、치입지가류형급규격여재협착적관계,연후행Logistic회귀득출결과.결과 144례중,추동맥기시부지가치입술후재협착39례(26.4％),균발생재술후5개월내.x2검험시:미협착조화재협착조재성별(남89화34례,녀16화5례；x2=0.804,p=0.370)、년령(≥60세60화21례；x2=2.358,P=0.125)、고혈압(67화28례；x2=0.253,P=0.615)、당뇨병(27화9례；x2=0.914,P=0.91)、관심병(32화6례；x2 =2.489,P=0.115)、고지혈증(6화5례；x2=0.478,p=0.489)、흡연(50화24례；x2=0.129,P=0.719)、음주(20화13례；x2 =0.001,P=0.978)、치입지가직경(≥4 mm 53화18례；x2=0.213,P=0.645)급지가장도(≥15 mm 45화19례；x2=0.927,P=0.336)、수술전후순배공혈불족증상(93화29례；x2=0.250,P=0.617)상차이무통계학의의(P＞0.05)；미협착조화재협착조재합병대측추동맥협착(43화24례；x2 =4.844,P=0.028)、합병경내동맥협착(49화26례；x2=4.558,P=0.033)、지가류형(약물지가59화11례；x2=8.916,P=0.003)상차이유통계학의의(P＜0.05).진행Logistic회귀분석현시:사용라지가화합병경내동맥협착위재협착적독립위험인소.결론 추동맥기시부지가치입술후재협착다발생우지가치입술후5개월내.합병경내동맥협착화사용라지가회증가술후재협착,술전후순배증상위주화합병대측추동맥기시부협착가능회증가재협착.
Objective To evaluate risk factors of restenosis of vertebral artery origin after stenting.Methods A total of 144 continuous cases were collected for this retrospective analysis.More than 50％ of stenosis in the original sites after treatment was defined as restenosis.Patients were divided into restenosis group (39 patients) and none-restenosis group (105 patients).The risk factors associated with restenosis were compared between the two groups by Chi-square test,including sex,age,presence of hypertension,diabetes,coronary heart disease,hyperlipidemia,smoking and drinking,the difference of preoperative neurological symptoms,combination with other vessels,stenosis,as well as stent type and stent size.Logistic regression was used to test the risk factors for restenosis.Results The incidence of restenosis of vertebral artery origin after stenting was 26.4％,and all of them occurred in 5 months.Between the two groups,there was no significant difference of distribution of sex (male 89,female 34,x2 =0.804,P =0.370),age(60 vs 21 patients of more than 60 years old,x2 =2.358,P =0.125),hypertension (67 vs 28 patients,x2 =0.253,P =0.615),diabetes (27 vs 9 patients,x2 =0.914,P =0.91),hyperlipidemia (6 vs 5 patients,x2 =0.478,P =0.489),coronary heart disease(32 vs 6 patients,x2 =2.489,P =0.115),smoking (50 vs 24 patients,x2 =0.129,P =0.719),drinking(20 vs 13 patients,x2 =0.001,P =0.978),diameter of stents (53 vs 18 patients of more than 4 mm,x2 =0.213,P =0.645),length of stents (45 vs 19 patients of more than 15 mm,x2 =0.927,P =0.336),preoperative neurological symptoms (93 vs 29 patients,x2 =0.250,P =0.617).There was significant difference of factors including combination with the bilateral stenosis (43 vs 24 patients,x2 =4.844,P =0.028),combination with the internal carotid artery stenosis(49 vs 26 patients,x2 =4.558,P =0.033) and stent types(59 vs 11 patients of drug eluting stent,x2 =8.916,P =0.003) between the two groups.Bare stents and combination with internal carotid artery stenosis were independent risk factors for restenosis by logistic regression.Conclusions The incidence of restenosis with vertebral artery origin occurs in 5 months after surgery.Bare stents and combination with internal carotid artery stenosis increased the incidence of restenosis,and preoperative neurological symptoms of vertebrobasilar system and presence of the bilateral stenosis may induce restenosis.
