颈动脉支架置入术后发生支架内再狭窄危险因素的Meta分析

Meta analysis of risk factors for in-stent restenosis after carotid artery stenting

目的探讨颈动脉支架置入(CAS)术后发生支架内再狭窄(ISR)的危险因素。方法检索PubMed、Embase、Web of Science、Cochrane Library、中国生物医学文献数据库、中国知网、维普中文科技期刊数据库、万方数据库,搜索CAS术后发生ISR危险因素的相关研究,检索时间为建库至2022年1月1日,采用Rev Man 5.4.1软件进行Meta分析。结果共纳入22篇文献,包括3篇队列研究,19篇病例对照研究。Meta分析结果显示,糖尿病、吸烟、高血压、高脂血症、外周动脉疾病、闭环支架、残余狭窄均是CAS术后发生ISR的危险因素(P﹤0.05),症状性颈动脉狭窄、开环支架均是CAS术后发生ISR的保护因素(P﹤0.05)。结论医务人员可参照上述因素对接受CAS的患者进行排查,制定相应的干预措施,以期降低再狭窄的发生率。

Objective To investigate the risk factors of intrastent restenosis(ISR)after carotid stent implantation(CAS).Method PubMed,Embase,Web of Science,the Cochrane Library,CBM,CNKI,VIP and Wanfang database were electronically searched to collect the studies about the risk factors for ISR after CAS from database inception to January 1,2022.Meta-analysis was performed by using Rev Man 5.4.1 software.Result A total of 22 articles were collected.The Meta-analysis results showed that diabetes,smoking,hypertension,hyperlipidemia,peripheral artery disease,closed-cell stents,and residual stenosis were risk factors for ISR after CAS,symptomatic carotid stenosis and open-cell stents were protective factors for ISR after CAS.Conclusion Healthcare professionals can refer to the above factors to screen patients undergoing CAS,and formulate corresponding intervention measures,to reduce the occurrence of in-stent restenosis.