动脉支架放置术前白细胞计数与锁骨下动脉支架远期通畅率的观察

An observation on preprocedural white blood cell count and long-term patency of stent implanted in subclavian artery

目的探讨动脉支架放置术前外周血白细胞计数与锁骨下动脉支架远期通畅率的相关性。方法用独立样本g检验回顾性分析因动脉硬化行锁骨下动脉支架置入术后支架通畅者（102例）与非通畅者（11例）术前白细胞计数的差异。用x^2检验分析术前白细胞计数较高（〉7．195×10^9／L）组（36例）与白细胞计数较低（≤7．195×10^9／L）组（77例）锁骨下动脉支架观察结束时支架通畅率的差异。结果113例患者术后随访1—3年，锁骨下动脉支架1年通畅率为96．5％（109／113），3年通畅率为89．6％（60／67）。11例非通畅患者的术前白细胞计数明显高于102例通畅患者（t=-5．051，P〈0．001），分另4为（8．3±1．1）×10^9／L（5．40×10^9／L～10．611×10^9／L）及（6．1±1．3）×10^9／L（4．10×10^9／L～8．00×10^9／L）。术前白细胞计数较高组及白细胞计数较低组观察结束时通畅率分别为75．0％（27／36）及97．4％（75／77）[P=0．001，OR值为12．500（95％CI为2．539～61．547）]。结论排除其他影响锁骨下动脉支架远期通畅率的传统因素之外，白细胞的增多与锁骨下动脉支架狭窄或阻塞的形成有关。

Objective To study relationship between preproeedural white blood cell count （WBC） and long-term pateney of stent implanted in the subclavian artery. Methods Data of 113 cases with stents implanted in the atherosclerotic subclavian arteries in Anzhen Hospital, Beijing during January 2005 to January 2008 were analyzed. Student t-test was used to compare the difference in WBC count between those with patency and those with stenosis after the procedure and ehi-square test was used to compare the difference in stent pateney between those with higher and lower WBC counts. Results There was significant difference in WBC counts between 102 cases with pateney and 11 eases with stenosis of the stents after implantation （t = -5. 051, P 〈 0. 001 ）. Percentage of patency of the stents in 36 cases with higher WBC count （ 〉7. 195 × 10^9/L） was significantly higher than that in 77 cases with lower WBC count （ ≤7. 195× 10^9/L） before the procedure （P = 0. 001 ）. Among 113 cases with stents implanted, 109 cases （96. 5% ） could keep their stents patent one year after implantation, and 60 cases （89. 6% ） could keep stents patent three years after implantation. Conclusions In addition to those traditional factors associated with long-term patency of stents after their implantation, increased WBC count also associated with stenosis or occlusion of the stents after the procedure.