文章摘要
夏宗梅 ，李斌 ，芦婷 ，张金平,.非急性颅外段颈内动脉闭塞再通可行性及开通失败的预测因素研究[J].神经损伤功能重建,2022,17(9):509-513
非急性颅外段颈内动脉闭塞再通可行性及开通失败的预测因素研究
Feasibility and Predictive Factors for Recanalization of Non-Acute Extracranial InternalCarotid Artery Occlusion
  
DOI：
中文关键词: 颈内动脉  非急性闭塞  血管内再通  Logistic回归模型
英文关键词: internal carotid artery  non-acute occlusion  endovascular recanalization  Logistic regression analysis
基金项目:山东省重点研发计 划项目（No. 2019G SF108138，No. 2019 GSF108132，No. 20 19GSF108033）
作者单位
夏宗梅1 ，李斌2 ，芦婷1 ，张金平1,3 1. 山东第一医科大 学第一附属医院神 经内科 2. 沂源县中医院神 经内科 3. 山东中医药大学 附属医院神经内科 
摘要点击次数: 1727
全文下载次数: 1877
中文摘要:
      目的：分析非急性颅外段颈内动脉闭塞再通可行性及影响开通的因素，并建立一个可预测闭塞再通 失败的模型。方法：纳入自2015年1月到2021年9月我中心经全脑血管造影确诊的动脉粥样硬化性颅外 段颈内动脉闭塞并接受血管内闭塞再通治疗的患者83例，分析血管开通失败的因素（性别、年龄、既往史、 发病到开通的时间、颈内动脉闭塞残端的角度、是否眼动脉返流），分析是否开通与相关自变量的多因素 Logistic回归分析，建立一个可预测颈内动脉闭塞开通失败的模型。结果：在83例患者中，成功开通48例， 手术的总体成功率为57.8%。多因素回归分析显示，颈内动脉闭塞开通失败的影响因素包括：年龄（OR 1.159，95%CI 1.041～1.328）、高血压（OR 6.213，95%CI 1.204～46.540）、冠心病（OR 0.025，95%CI 0.001～ 0.254）、糖尿病（OR 0.157，95%CI 0.014～1.108）、颈内动脉闭塞残端角度（OR 0.082，95%CI 0.008～ 0.550）、眼动脉未返流至海绵窦段（OR 0.002，95%CI 0～0.021）。将Logistic多因素回归分析得出的危险因 素纳入预测模型并绘制列线图，该模型的ROC曲线下面积（AUC值）为0.947（95%CI 0.898～0.996）。结 论：非急性颅外段颈内动脉闭塞再通技术上可行。男性、年龄越高、无冠心病、无糖尿病、颈内闭塞角度是 钝角、眼动脉无返流是开通失败的预测因子。
英文摘要:
      To investigate the feasibility of recanalization of non-acute extracranial internal carotid artery occlusion and the factors affecting recanalization, and to establish a model which can predict the probability of failed recanalization. Methods: In this study, 83 consecutive patients who underwent endovascular recanalization for atherosclerotic extracranial internal carotid artery occlusion from January 2015 to September 2021 in our stroke center were enrolled. The potential risk factors of failed recanalization (gender, age, past history, time from onset to recanalization, angle of the occlusion stump of the internal carotid artery, and whether there was ophthalmic artery regurgitation) were analyzed. A Logistic regression analysis of these factors was utilized to establish a model that could predict the ratio of failed recanalization. Results: Among the 83 patients, 48 were successfully recanalized, and the overall success rate of the operation was 57.8% . Multivariate regression analysis showed that the factors associated with failure of recanalization of internal carotid artery occlusion were age (OR=1.159, 95% CI=1.041～1.328), hypertension (OR=6.213, 95% CI= 1.204～46.54), coronary heart disease (OR=0.025, 95% CI=0.001～0.254), diabetes (OR=0.157, 95% CI= 0.014～1.108), obtuse angle of internal cervical occlusion (OR=0.082, 95% CI=0.008～0.550)，and absence of ophthalmic artery regurgitation (OR=0.002, 95% CI=0～0.021). The risk factors of Logistic regression analysis were included in the prediction model and the nomogram was drawn. The area under the ROC curve (AUC value) of the model was 0.947(95% CI=0.898～0.996). Conclusion: Endovascular recanalization of non-acute extracranial internal carotid artery occlusion is technically feasible. Male gender, older age, coronary heart disease, obtuse angle of internal cervical occlusion, and absence of ophthalmic artery regurgitation are predictors of failed recanalization.
查看全文   查看/发表评论  下载PDF阅读器
关闭