临床医学毕业论文症状性椎基底动脉狭窄患者支架置入术后再狭窄相关因素分析.doc

X X 大学 毕业论文 症状性椎基底动脉狭窄患者支架置入术后再狭窄相关因素分析 姓 名：__________ 2014年6月25日 症状性椎基底动脉狭窄患者支架置入术后再狭窄相关因素分析 作者：杨玉峰 张殿印 侯玉芹 【摘要】 目的 探讨症状性椎基底动脉（VBA）狭窄患者支架置入术后再狭窄与临床因素的关系。 方法 收集我院36例症状性VBA狭窄且行支架置入术患者的临床资料，以经颅多普勒（TCD）、彩色多普勒超声（CDI）、数字减影血管造影（DSA）随访支架置入术后的再狭窄率。选择了脑梗死易患因素、靶病变长度、靶病变部位等11项观察指标，分析上述各种临床因素与再狭窄的相关性，对有、无相关危险因素再狭窄率采用卡方检验。 结果 36例患者有40处狭窄，置入支架40枚，平均随访时间为（16.5±15.4）个月（3个月～3年），TCD、CDI随访30例，DSA随访6例，8例（8/36,22.2%）出现＞50%的再狭窄。再狭窄组病人合并有糖尿病史比例较无再狭窄组明显增多（分别为62.5%、32.1%，P＜0.05）；再狭窄组椎动脉开口病变比例明显高于无再狭窄组（分别为62.5%、39.3%，P＜0.05）；再狭窄组的靶病变≥10mm明显高于无再狭窄组（分别为50.0%、28.6%，P＜0.05）。结论 症状性椎基底动脉狭窄支架置入术患者合并糖尿病、椎动脉开口病变及靶病变长度可能是术后再狭窄的预测因素。 【关键词】 椎基底动脉；支架；危险因素；再狭窄 【Abstract】 Objective To investigate the clinical correlated factors of restenosis in patients with symptomatic vertebrobasilar artery(VBA) stenosis after stenting. Methods The clinical data of 36 patients with symptomatic VBA stenosis after stenting were analyzed. The restenosis rate after stenting was followedup with transcranial Doppler(TCD)，color Doppler imaging(CDI) and digital subtraction angiography(DSA). Eleven factors including cerebral infarction risk factors,target lesion length and target lesion position etc were chosed, and then the data and their correlations with restenosis were analyzed. The significant differences for the restenosis rate with and without related risk factors were examined by ChiSquare test. Results There were 40 stenosis in 36 patients, and 40 stents were placed in these patients.The mean followup time was 16.5±15.4 months.Thirty patients were followedup with TCD，CDI,and six with DSA,eight patients(8/36,22.2%) had restenosis more than 50%.The percentage of diabetic mellitus history in restenosis group was higher than nonrestenosis group(62.5%，32.1% separately，P＜0.05);The percentage of target lesions in vertebral artery ostium in restenosis group was higher than nonrestenosis group(62.5%，39.3% separately，P＜0.05);The percentage of target lesions length≥10mm in re