摘要
目的:探讨彩色多普勒超声对颈动脉狭窄支架成形术(carotid artery stenting,CAS)患者疗效及术后残余狭窄的评估价值。方法:前瞻性选取2018年1月至2020年9月在池州市人民医院神经外科治疗的110例CAS患者,对比手术前后超声相关测量指标。依据数字减影血管造影(digital subtraction angiography,DSA)检查统计术后残余狭窄发生率,并分为残余狭窄组与正常组(未发生残余狭窄)。比较两组临床资料和超声相关指标,并分析CAS术后残余狭窄发生的影响因素。结果:CAS术后狭窄部位狭窄程度[(26.51±5.78)%]低于术前[(83.57±10.20)%],术后颈动脉近中端、颈动脉远端的收缩期血流峰值流速(peak systolic velocity,PSV)、舒张期末流速(end diastolic velocity,EDV)也均较术前显著下降,差异有统计学意义(P<0.05)。CAS术后残余狭窄发生率为22.73%。残余狭窄组CAS术后颈动脉近中端PSV[(131.48±11.92)cm/s]、EDV[(47.20±5.24)cm/s]均高于正常组[(98.86±10.26)cm/s、(38.14±5.06)cm/s],斑块形态不规则(76.00%)、斑块钙化(72.00%)发生率均明显高于正常组(38.82%、61.18%),差异有统计学意义(P<0.05)。多因素logistic回归分析显示:斑块形态不规则(OR=1.572,95%CI:1.021~2.256)、斑块钙化(OR=2.380,95%CI:1.364~3.527)均是CAS患者发生术后残余狭窄的独立危险因素(P<0.05)。结论:彩色多普勒超声能有效评估CAS血管再通的疗效和观察有无残余狭窄,斑块形态不规则和斑块钙化是CAS术后残余狭窄发生的危险因素。
Objective:To investigate the value of color Doppler ultrasound in evaluating the efficacy of carotid artery stenting(CAS)and residual stenosis after operation.Methods:A total of 110 CAS patients treated in the neurosurgery department of Chizhou People’s Hospital from January 2018 to September 2020 were prospectively selected,and the relevant measurement indexes of ultrasound before and after operation were compared.According to digital subtraction angiography(DSA),the incidence of postoperative residual stenosis was analyzed and divided into residual stenosis group and normal group(no residual stenosis).The clinical data and ultrasound related indexes were compared between the two groups,and the influencing factors of residual stenosis after CAS were analyzed.Results:The stenosis degree of stenosis site after CAS was(26.51±5.78)%,which was lower than that before[(83.57±10.20)%].The peak systolic velocity(PSV)and end diastolic velocity(EDV)of proximal and distal carotid artery after CAS were significantly lower than those before CAS(P<0.05).DSA confirmed that the incidence of residual stenosis was 22.73%.PSV[(131.48±11.92)cm/s]and EDV[(47.20±5.24)cm/s]in the residual stenosis group were significantly higher than those in the normal group[(98.86±10.26)cm/s and(38.14±5.06)cm/s].The plaque morphology was irregular(76.00%)and plaque calcification(72.00%)in the residual stenosis group were significantly higher than those in the normal group(38.82%and 61.18%)(P<0.05).Multivariate logistic regression analysis showed that irregular plaque shape(OR=1.572,95%CI:1.021–2.256)and plaque calcification(OR=2.380,95%CI:1.364–3.527)were independent risk factors for postoperative residual stenosis in patients with CAS(P<0.05).Conclusion:Color Doppler ultrasound can effectively evaluate the effects of CAS recanalization and observe whether there is residual stenosis.Irregular plaque shape and plaque calcification are the risk factors of residual stenosis after CAS.
作者
蔡杜娟
包继开
CAI Dujuan;BAO Jikai(Department of Ultrasound,Chizhou People’s Hospital,Chizhou Anhui 247100,China)
出处
《临床与病理杂志》
CAS
2022年第1期110-116,共7页
Journal of Clinical and Pathological Research
关键词
颈动脉狭窄支架成形术
彩色多普勒超声
疗效
术后残余狭窄
评估价值
carotid artery stenosis stenting
color Doppler ultrasound
curative effect
postoperative residual stenosis
evaluation value
