颈动脉完全闭塞患者血管再通术的预后变化及相关因素分析

Outcome in complete carotid artery occlusion patients after vascular recanalization and its related factors

目的探讨症状性颈动脉完全闭塞患者血管再通术的安全性、有效性及相关影响因素。方法选择62例症状性颈动脉完全闭塞患者,分为介入组21例(血管再通术)和药物组41例。随访发病2年时功能预后,以改良的Rankin量表(mRS)评分表示,行多因素logistic回归分析。结果介入组患者在3、6个月、1及2年随访时,mRS平均秩次均低于药物组(P<0.05,P<0.01)。logistic回归分析显示,mRS评分与吸烟(P=0.036)、美国国立卫生研究院卒中量表评分(P=0.018)、介入治疗(P=0.003)相关,其中介入治疗是预后独立保护因素。结论血管再通术治疗症状性颈动脉完全闭塞患者可能是安全有效的,可能是患者功能预后的独立保护因素。

Objective To study the safety and efficiency of vascular recanalization in symptomatic complete carotid artery occlusion patients and its related factors.Methods Sixty-two symptomatic complete carotid artery occlusion patients were divided into intervention group （n=21） and drug treatment group （n=42）.The patients were followed up for 2 years during which their outcomes were recorded according to the modified Rankin Scale （mRS） and analyzed by multivariate logistic regression analysis.Results The patients were followed up for 3,6,12 and 24 months during which the mRS was lower in intervention group than in drug treatment group （P＜0.05,P＜0.01）.Multivariate logistic regression analysis showed that the mRS score was related with smoking （P=0.036）,NIHSS （P=0.018）,and intervention （P=0.003）.Intervention was an independent protective factor for the outcome in symptomatic complete carotid artery occlusion patients.Conclusion Vascular recanalization is a safe and effective procedure for complete symptomatic carotid artery occlusion and may be an independent protective factor for the outcome in complete symptomatic carotid artery occlusion patients.