糖尿病合并下肢动脉硬化闭塞症行血管腔内介入术治疗后预后及发生再狭窄的影响因素分析

Analysis of Prognosis and Influencing Factors of Restenosis after Endovascular Intervention in Diabetes Patients with Lower Extremity Arteriosclerosis Obliterans

目的:探讨糖尿病合并下肢动脉硬化闭塞症行血管腔内介入术治疗后预后及发生再狭窄的影响因素。方法:选取我院2022年1月到2022年12月收治的100例糖尿病合并下肢动脉硬化闭塞症患者,所有患者均采取血管腔内介入术治疗,分析患者治疗情况,随后对患者进行随访,记录发生再狭窄的人数,分别以短期预后情况(预后良好=0,预后不良=1)及发生再狭窄情况(非再狭窄=0,再狭窄=1)作为因变量,建立logistics回归模型分析其预后及发生再狭窄的独立影响因素。结果:100例糖尿病合并下肢动脉硬化闭塞症患者行血管腔内介入术治疗,住院时间为(13.43±2.42)d,治疗费用为(73453.43±1253.64)元,总有效率为80.00%,心脑血管事件发生率为5.00%,截肢率为4.00%,随访1年再狭窄发生率为25.00%;预后不良组与预后良好组患者年龄、下肢动脉硬化闭塞症病程、踝肱指数、纤维蛋白原、总胆固醇、吸烟史、合并高脂血症情况对比差异显著(P<0.05),再狭窄组与非再狭窄组患者空腹血糖、纤维蛋白原、总胆固醇、糖化血红蛋白、吸烟史、合并高脂血症、合并慢性肾功能不全情况对比差异显著(P<0.05);影响预后不良的因素有年龄、踝肱指数、纤维蛋白原、总胆固醇、合并高脂血症等(P<0.05);影响治疗后再狭窄的因素有纤维蛋白原、糖化血红蛋白、吸烟史、合并高脂血症、合并慢性肾功能不全等(P<0.05)。结论:糖尿病合并下肢动脉硬化闭塞症行血管腔内介入术治疗后总有效率为80.00%,再狭窄发生率为25.00%,纤维蛋白原、合并高脂血症为预后不良及再狭窄的共有影响因素,其中预后不良影响因素还包括年龄、踝肱指数、总胆固醇,再狭窄影响因素还包括糖化血红蛋白、吸烟史、慢性肾功能不全。

Objective:To investigate the prognosis and the influencing factors of restenosis after endovascular intervention in diabetes patients with lower extremity arteriosclerosis obliterans.Methods:100 patients with diabetes complicated with arteriosclerosis obliterans of lower extremities admitted to our hospital from January 2022 to December 2022 were selected.All patients were treated with endovascular intervention,and the treatment conditions were analyzed.Then,the patients were followed up,and the number of patients with restenosis was recorded,A logistic regression model was established to analyze the independent influencing factors of short-term prognosis(good prognosis=0,poor prognosis=1)and occurrence of restenosis(non restenosis=0,restenosis=1)as dependent variables.Results:100 diabetic patients with lower extremity arteriosclerosis occlusion were treated by endovascular intervention,the length of hospital stay was(13.43±2.42)d,the cost of treatment is RMB(73453.43±1253.64),the total response rate was 80.00%,The incidence of cardiovascular and cerebrovascular events was 5.00%,the amputation rate was 4.00%,the incidence of restenosis at 1-year follow-up was 25.00%;Significant difference between poor prognosis group and good prognosis group:age,duration of lower extremity arterioscle rosis occlusion,ankle-brachial index,fibrinogen,total cholesterol,smoking history,and combined hyperlipidemia(P<0.05),Fasting blood glucose,fibrinogen,total cholesterol,glycated hemoglobin,smoking history,hyperlipidemia,and chronic renal insufficiency between restenosis and non-restenosis patients(P<0.05);The factors affecting poor prognosis were age,ankle brachial index,fibrinogen,total cholesterol,and hyperlipidemia(P<0.05);the factors influencing treatment restenosis were fibrinogen,hemoglobin A 1 c,smoking history,hyperlipidemia,with chronic renal insufficiency(P<0.05).Conclusion:The total effective rate of endovascular intervention for diabetes patients with lower extremity arteriosclerosis obliterans is 80.00%,and the incidence of restenosis is 25.00%.Fibrinogen and hyperlipidemia are the common influencing factors for poor prognosis and restenosis,among which age,ankle brachial index,total cholesterol are also the influencing factors for poor prognosis,and the influencing factors for restenosis include glycosylated hemoglobin,smoking history,and chronic renal insufficiency.