在 carotid 动脉支架后患有血液动力学抑郁症的患者的临床分析
Peng Wei1, Qi Deng2, Chao Wen1
1Department of Neurology, Taiyuan Central Hospital, Shanxi Medical University, Taiyuan, Shanxi Province, China.
Heliyon
|December 11, 2023
概括
在动脉支架 (CAS) 后持续的血液动力学抑郁症 (p-HD) 影响了18.5%的患者. 高血压,先前的中风/TIA,CAD和损伤距离是关键预测因素,增加中风风险和ICU停留时间.
科学领域:
- 心血管医学 心血管医学
- 干预心脏病学 干预心脏病学
- 神经学 神经学
背景情况:
- 血液动力学抑郁症 (HD) 是一个已知的并发症,随着动脉支架 (CAS).
- 预测术后风险因素和临床结果,特别是在高风险人群中,仍然具有挑战性.
- 持续性HD (p-HD) 和固执性HD (op-HD) 需要进一步调查其发生率和CAS后的临床意义.
研究的目的:
- 在CAS后确定p-HD和op-HD的发病率.
- 确定与p-HD发展相关的临床预测因素.
- 评估p-HD/op-HD对术后不良事件的临床意义和影响,特别是中风.
主要方法:
- 在2020年9月至2022年9月期间,对162名患有动脉硬化狭窄症 (CASS) 的患者进行了回顾性分析,这些患者接受了CAS.
- 后勤回归分析以确定p-HD的独立预测因子.
- 评估p-HD/op-HD与30天临床事件之间的病理关联,包括中风和ICU停留时间.
主要成果:
- p-HD的发病率为18.5% (30/162名患者),而op-HD为5.6% (9/162名患者).
- 对于p-HD的独立预测因素包括高血压 (OR:8.73),中风/暂时性缺血性发作 (TIA) 的病史 (OR:4.05),冠状动脉疾病 (CAD) (OR:3.38),以及病变距离动脉分叉 (OR:2.467).
- 患有p-HD或op-HD的患者经历了显著更长的ICU停留时间 (P < 0.001) 和更高的中风风险 (p-HD的P = 0.003,op-HD的P < 0.001).
结论:
- 高血压,先前的中风/TIA,CAD,以及病变接近动脉分叉是p-HD后CAS的显著预测因素.
- 无论是p-HD还是op-HD都与不良的临床结果有关,包括长时间入住ICU和增加中风风险.
- 这些发现强调了识别p-HD高风险患者的重要性,以减轻CAS后的潜在并发症.
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