| 姜海波,王小姗,曹 辉,龚凯琳,陈奇琦.支架置入术治疗椎动脉起始段狭窄的临床疗效及术后支架内再狭窄的影响因素分析[J].,2020,(22):4274-4278 |
| 支架置入术治疗椎动脉起始段狭窄的临床疗效及术后支架内再狭窄的影响因素分析 |
| Clinical Efficacy of Stent Implantation in the Treatment of Vertebral Artery Origin Stenosis and the Influence Factors of Postoperative In-stent Restenosis |
| 投稿时间：2020-06-06 修订日期：2020-06-30 |
| DOI：10.13241/j.cnki.pmb.2020.22.016 |
| 中文关键词: 支架置入术 椎动脉起始段狭窄 临床疗效 术后 支架内再狭窄 影响因素 |
| 英文关键词: Stent implantation Vertebral artery origin stenosis Clinical efficacy Postoperative In-stent restenosis Influencing factors |
| 基金项目:国家自然科学基金面上项目（81271440） |
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| 中文摘要: |
| 摘要 目的：研究支架置入术（SI）治疗椎动脉起始段狭窄（VAOS）的临床疗效及术后支架内再狭窄（ISR）的影响因素。方法：选择从2018年1月到2020年2月在我院接受SI治疗的VAOS患者83例纳入本次研究。剔除1例手术失败及1例死亡患者的病例后，对剩余81例患者根据患者是否发生ISR，将其分成ISR组28例和无ISR组53例。随访分析患者的临床疗效，对患者发生ISR进行单因素及多因素Logistic回归分析，同时分析患者美国国立卫生院卒中量表（NIHSS）评分与血管狭窄情况及血流动力学指标的相关性。结果：83例VAOS患者接受SI术式治疗后，手术成功率为98.80%（82/83）。术后有3例患者发生动脉痉挛，另有1例患者在术后7 d由于继发脑出血而死亡，并发症的总发生率为4.82%（4/83）。ISR组的高脂血症、合并颈内动脉的狭窄、椎动脉的狭窄部位为双侧、支架类型为裸支架的比例分别高于无ISR组（均P＜0.05）。根据Pearson法分析相关性显示，患者NIHSS评分与血管狭窄率、狭窄血管长度、收缩期峰值流速（PSV）和舒张期末流速（EDV）均呈正相关（P＜0.05）。根据Logistic回归分析显示，患者发生ISR影响因素包含高脂血症和支架类型为裸支架，以及合并颈内动脉的狭窄和并发双侧椎动脉的狭窄（P＜0.05）。结论：SI术式治疗的VAOS患者的临床疗效较好，且术后ISR的影响因素主要包含高脂血症和支架类型为裸支架，以及合并颈内动脉的狭窄和并发双侧椎动脉的狭窄，临床上应引起相应的重视。 |
| 英文摘要: |
| ABSTRACT Objective: To study the clinical efficacy of stent implantation(SI) in the treatment of vertebral artery origin stenosis(VAOS) and the influencing factors of postoperative in-stent restenosis(ISR). Methods: 83 VAOS patients who were received SI treatment from January 2018 to February 2020 were included in this study. After excluding 1 case of failed operation and 1 case of death, the remaining 81 patients according to whether they had ISR incidence were divided into ISR group with 28 cases and no ISR group with 53 cases. The patient's clinical efficacy was follow-up analyzed, single factor and multivariate logistic regression analysis was used to analyze the ISR incidence. The correlation between National Institutes of Health Stroke Scale(NIHSS) score and vascular stenosis and hemodynamic indexes were analyzed. Results: 83 VAOS patients received SI surgical after treatment, the success rate of operation was 98.80% (82/83). There were 3 patients with arterial spasm, and 1 patient died of secondary cerebral hemorrhage 7 d after operation, the total incidence rate of complications was 4.82% (4/83). The proportion of hyperlipidemia, internal carotid artery stenosis, bilateral vertebral artery stenosis and stent type as bare stent in ISR group were higher than those in non ISR group (all P＜0.05). According to Pearson analysis, NIHSS score was positively correlated with stenosis rate, stenosis vessels length, peak systolic velocity (PSV) and end diastolic velocity (EDV) (P＜0.05). According to Logistic regression analysis, the influencing factors of ISR incidence included hyperlipidemia, stent type as bare stent, internal carotid artery stenosis and bilateral vertebral artery stenosis (P＜0.05). Conclusion: The clinical efficacy of SI surgical treatment for VAOS patients is good, and the influencing factors of postoperative ISR mainly include hyperlipidemia and stent type as bare stent, combined with internal carotid artery stenosis and bilateral vertebral artery stenosis, which should be paid attention to clinically. |
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