贫血对股腘动脉硬化闭塞症患者药物涂层球囊治疗后再狭窄的影响

The effect of anemia on restenosis in patients with femoropopliteal atherosclerotic occlusion after drugcoated balloon angioplasty

目的评价贫血与股腘动脉硬化闭塞症(ASO)患者药物涂层球囊(DCB)治疗后再狭窄的关系。方法回顾性分析单中心2017年1月至2018年12月共91例接受DCB治疗的股腘动脉ASO患者临床资料。根据术前患者是否存在贫血分为贫血组(n=36)和无贫血组(n=55)。对比术后12个月一期通畅率。多因素logistic回归法分析再狭窄危险因素。结果 91例患者平均年龄(70.76±7.51)岁,男63例。Kaplan-Meier生存曲线分析显示,DCB术后12个月一期通畅率为80.2%。共有18例患者发生再狭窄,其中贫血组12例(33.3%),无贫血组6例(10.9%),差异有显著统计学意义(P=0.009);再狭窄组贫血患者占比(66.7%),大于无再狭窄组(32.9%)(P=0.009);贫血组患者术后12个月一期通畅率(66.7%)显著低于无贫血组患者(89.1%)(Log-rank P=0.006)。多因素logistic回归分析结果显示,贫血(OR=5.297,95%CI=1.179~23.800,P=0.030)、重度钙化(OR=12.213,95%CI=1.806~82.579,P=0.010)是股腘动脉ASO患者DCB术后再狭窄的危险因素。结论贫血与股腘动脉ASO患者DCB术后再狭窄风险显著相关。

Objective To evaluate the correlation between anemia and restenosis in patients with femoropopliteal atherosclerotic occlusion(ASO) after drug-coated balloon(DCB) angioplasty. Methods The clinical data of 91 patients with femoropopliteal ASO, who received DCB angioplasty at a single center between January 2017 and December 2018, were retrospectively analyzed. According to the presence or absence of anemia, the patients were divided into anemia group(n=36) and non-anemia group(n=55). The postoperative12-month primary vascular patency rate was compared between the two groups. Multivariate logistic regression method was used to analyze the risk factors for restenosis. Results The 91 patients included 63 males, and the mean age was(70.76±7.51) years. Kaplan-Meier survival curve analysis showed that 12 months after DCB angioplasty the primary vascular patency rate was 80.2%. A total of 18 patients developed restenosis,including 12 patients of anemia group(33.3%) and 6 patients of non-anemia group(10.9%), the difference between the two groups was statistically significant(P=0.009). Anemia was present in 66.7% of patients who developed restenosis, which was strikingly higher than 32.9% of patients who did not develop restenosis(P=0.009). The postoperative 12-month primary vascular patency rate in anemia group was 66.7%, which was prominently lower than 89.1% in non-anemia group(Log-rank P=0.006). Multivariate logistic regression analysis indicated that anemia(OR=5.297, 95%CI=1.179-23.800, P=0.030) and severe calcification(OR=12.213,95% CI =1.806-82.579, P =0.010) were risk factors for restenosis in patients with femoropopliteal ASO after DCB angioplasty. Conclusion The presence of anemia bears a close relationship to the occurrence of restenosis in patients with femoropopliteal ASO after DCB angioplasty.(J Intervent Radiol, 2021, 30: 799-803)