颈动脉支架成形术后持续性低血压危险因素分析

Analysis of the risk factors related to the persistent hypotension occurring after carotid angioplasty and stenting

目的探讨颈动脉狭窄患者颈动脉支架成形术(CAS)后产生持续性低血压的危险因素。方法回顾2014年1月至2015年11月在北京宣武医院接受CAS治疗的颈动脉狭窄患者共106例,采用单因素及Logistic多因素回归法分析发生持续性低血压的危险因素。结果 CAS术后106例患者中30例发生持续性低血压,发生率为28.3%。单因素分析提示年龄≤65岁、无高血压病史、狭窄部位在球部、对侧颈动脉重度狭窄/闭塞、有溃疡斑块,与术后发生持续性低血压有关。多因素分析结果提示年龄≤65岁、有溃疡斑块,为术后持续性低血压独立危险因素。结论年龄≤65岁、有溃疡斑块的颈动脉狭窄患者CAS术后容易发生持续性低血压。

Objective To investigate the risk factors related to the persistent hypotension occurring after carotid angioplasty and stenting（CAS） in patients with carotid artery stenosis. Methods The clinical data of 106 patients with carotid artery stenosis, who were treated with CAS at authors＇ hospital during the period from January 2014 to November 2015, were retrospectively analyzed. The risk factors related to the persistent hypotension were evaluated by univariate and logistic multivariate regression analysis. Results After CAS, a total of 30 patients among the 106 patients developed persistent hypotension, the incidence rate was 28.3%. Univariate analysis indicated that the factors associated with the occurrence of postoperative persistent hypotension included patient＇s age≤65 years, no history of hypertension, stenosis in the carotid bulb, severe stenosis or occlusion of contralateral carotid artery, and presence of ulceration plaque. Multivariate regression analysis revealed that the patient＇s age ≤ 65 years and the presence of ulceration plaque were the independent risk factors related to the persistent hypotension after CAS. Conclusion The patients with carotid stenosis, who are ≤ 65 years and have ulceration plaque, are apt to develop persistent hypotension after CAS.