老年下肢动脉硬化闭塞症的高危因素及下肢动脉旁路移植术治疗效果分析

Analysis of High Risk Factors of Elderly Lower Extremity Arteriosclerosis Obliterans and the Therapeutic Effect of Lower Extremity Arterial Bypass Grafting

目的:分析老年下肢动脉硬化闭塞症(PAD)的高危因素及下肢动脉旁路移植术治疗效果。方法:选取2019年1月至2020年1月本院收治的90例老年PAD患者为病例组,另取同期于本院进行健康体检的90例老年人为体检组,收集可能影响老年人发病的因素,采用单因素和多因素Logistic回归分析PAD发病因素。将病例组患者按简单随机分组法分为观察组(n=45)和对照组(n=45),观察组行下肢动脉旁路移植术,对照组行腔内血管形成术,比较两组胫后和足背动脉指标、氧化应激反应[超氧化物歧化酶(SOD)、丙二醛(MDA)]及术后不良反应。结果:单因素结果显示,病例组吸烟史、高血压、糖尿病、冠心病及慢性肾功能不全的比例明显高于体检组(P<0.05);Logistic回归分析结果显示,高血压、糖尿病、冠心病、慢性肾功能不全是老年人发生PAD的独立危险因素(P<0.05);治疗后,观察组胫后和足背动脉指标水平治疗前后差值明显高于对照组(P<0.05),SOD水平明显低于对照组(P<0.05),MDA水平明显高于对照组(P<0.05),不良反应总发生率明显高于对照组(26.67%vs8.89%,P<0.05)。结论:高血压、糖尿病、冠心病、慢性肾功能不全是老年PAD的高危因素,下肢动脉旁路移植术对治疗老年PAD患者具有较好的疗效,而氧化应激反应较严重,术后不良反应发生率也较高。

Objective:To analyze the risk factors of lower extremity arteriosclerotic occlusive disease(PAD)in elderly patients and the therapeutic effect of lower extremity arterial bypass grafting.Methods:A total of 90 elderly patients with PAD admitted to our hospital from January 2019 to January 2020 were selected as the case group,and another 90 elderly patients who underwent physical examination in our hospital during the same period were selected as the physical examination group.The factors that may affect the incidence of the elderly were collected,and the risk factors for the incidence of PAD were analyzed by univariate and multivariate Logistic regression.Patients in the case group were divided into observation group(n=45)and control group(n=45)by simple random grouping.The observation group underwent lower limb artery bypass grafting,and the control group underwent endovascular angiogenesis.The indexes of posterior tibial and dorsal foot arteries,oxidative stress response[superoxide dismutase(SOD),malondialdehyde(MDA)]and postoperative adverse reactions were compared between the two groups.Results:Univariate results showed that the incidence of smoking history,hypertension,diabetes,coronary heart disease and chronic renal insufficiency were 16.67%、28.89%、27.78%、12.22%and 18.89%in case group,significantly higher than 4.4%、15.56%、15.56%、3.33%and 5.56%of physical examination group(P<0.05);multivariate Logistic regression analysis showed that hypertension,diabetes,coronary heart disease and chronic renal insufficiency were independent risk factors for PAD in the elderly(P<0.05).After treatment,the difference of posterior tibial artery and dorsal foot artery before and after treatment in the observation group was significantly higher than that in the control group(P<0.05),SOD level was significantly lower than that in control group(P<0.05),MDA level was significantly higher than that in control group(P<0.05),and the total incidence of adverse reactions was significantly higher than that in control group(26.67%vs 8.89%,P<0.05).Conclusion:Hypertension,diabetes,coronary heart disease and chronic renal insufficiency are the high risk factors for elderly patients with PAD.Lower limb artery bypass grafting has a good effect on the treatment of elderly patients with PAD,and the oxidative stress reaction is more serious,and the incidence of postoperative adverse reactions is high.Therefore,the treatment plan can be selected according to the actual situation of patients.