行血管内介入手术治疗非急性期眼段症状性ICAO患者预后不良的危险因素

Risk factors for poor prognosis in patients with symptomatic ocular ICAO undergoing endovascular intervention

目的探讨行血管内介入手术治疗非急性期眼段症状性颈内动脉闭塞(Internal carotid artery occlusion, ICAO)患者预后不良的危险因素。方法回顾性分析本院2010年1月-2018年12月收治并行血管内介入手术治疗非急性期眼段症状性ICAO患者共216例的临床资料,根据随访2年预后情况分组,采用Logistic回归模型评价预后不良的独立危险因素。结果入选且接受血管内介入手术患者出院当天实现血管开通208例,开通成功率为96.30%(208/216),预后不良率为19.23%(40/208);同时出院当天改良Rankin量表(Modified Rankin scale, mRS)评分和美国国立卫生院神经功能缺损量表(Natinal Institute of health strke scale, NIHSS)评分均显著少于入院当天(P<0.05);2组年龄、合并高血压病、2型糖尿病(Type 2 diabetes, T2DM)及冠心病的比例均有明显差异(P<0.05);Logistic回归模型多因素分析显示,合并高血压病和T2DM是行血管内介入手术治疗非急性期眼段症状性ICAO患者预后不良的独立危险因素(P<0.05)。结论行血管内介入手术治疗非急性期眼段症状性ICAO患者预后不良与合并高血压病和T2DM关系密切。

Objective To investigate the risk factors for poor prognosis in patients with symptomatic ocular ICAO undergoing endovascular intervention. Methods Clinical data of 216 patients with symptomatic ocular ICAO undergoing endovascular intervention were retrospectively selectedduring the period from January 2010 to December 2018. All patients were grouped according to the clinical prognosis for 2-year follow-up. Logistic regression model was used to evaluate the independent risk factors of poor prognosis. Results 208 cases in all patients achieved vascular opened after endovascular treatment and the success rate was 96.30%(208/216) and the poor prognosis rate was 19.23%(40/208). The mRS score and NIHSS score after treatment were significantly lower than untreatment(P<0.05). There were significant differences in age, combination proportion of hypertension, T2 DM and coronary heart disease between 2 groups(P<0.05). Multivariate logistic regression analysis showed that hypertension and T2 DM were independent risk factors for poor prognosis in patients with non acute ocular symptomatic ICAO(P<0.05). Conclusion The poor prognosis of patients with non acute ocular symptomatic ICAO treated by endovascular intervention is closely related to hypertension and T2 DM.