颈内动脉闭塞患者71例的5年随访分析

Five-Year Prognosis of 71 Patients with Internal Carotid Artery Occlusion

目的:对颈内动脉闭塞(ICAO)患者进行5年随访,观察及评估预后情况,并对其影响因素进行分析。方法:收集71例ICAO患者作为研究对象,收集患者临床资料;采用电话随访方式随访5年,根据改良Rankin评分(mRS)将ICAO患者分为结局良好组(mRS≤2分)和结局不良组(mRS>2分);对可能影响患者预后的因素进行统计学分析。结果:随访5年后,纳入预后良好组48例(67.60%),预后不良组23例(32.29%)。坚持口服抗血小板药物(阿司匹林/氯吡格雷)、口服他汀的患者相对预后良好,合并房颤、既往卒中史,高同型半胱氨酸(HCY)及高胆固醇(TC)血症的患者相对预后不良,2组间差异具有统计学意义(P<0.05)。经过Logistic回归分析,口服抗血小板药物(阿司匹林/氯吡格雷)、合并房颤、HCY和TC水平与ICAO患者预后相关(P<0.05)。结论:ICAO患者5年的预后总体水平较好。坚持口服抗血小板药物(阿司匹林/氯吡格雷)的ICAO患者预后相对良好,合并房颤、高HCY和高TC血症的ICAO患者预后不良。

Objective:Patients with internal carotid artery occlusion(ICAO)were followed up for 5 years to observe prognosis and analyze patient risk factors.Methods:We collected the clinical data of 71 patients diagnosed with ICAO.Patients received telephone follow-up for 5 years.According to the Modified Rankin Scale(mRS),patients were divided into the good prognosis group(mRS≤2)and poor prognosis group(mRS>2).Analysis was performed to evaluate the association between certain biomarkers and prognosis.Results:There were 48 cases(67.60%)in the good prognosis group and 23 cases(32.29%)in the poor prognosis group after the 5-year follow-up.Patients who adhered to oral antiplatelet drugs(aspirin/clopidogrel)and oral statin had a better prognosis,while patients with atrial fibrillation,prior stroke history,high homocysteine(HCY),and high cholesterol(TC)had a poorer prognosis,with statistical differences between the two groups(P<0.05).Logistic regression analysis showed that oral antiplatelet drugs(aspirin/clopidogrel),atrial fibrillation,and HCY and TC levels were correlated with prognosis in ICAO patients(P<0.05).Conclusion:The overall prognosis of ICAO patients at 5 years was good.ICAO patients who adhered to oral antiplatelet drugs(aspirin/clopidogrel)had a better prognosis,while those with atrial fibrillation,high HCY,and high TC had a poorer prognosis.