摘要
目的探讨颈内动脉支架成形术(CAS)对中远期血压的影响与中远期血压下降的相关因素。方法选取2020年12月⁃2021年12月于本院行CAS治疗的54例患者为研究对象。对比54例患者术前24h与术后24h、术后1个月、术后6个月的血压水平;依照术后6个月收缩压下降情况分为收缩压下降组(收缩压下降≥10mmHg)与收缩压无下降组(收缩压下降<10mmHg),收集所有患者的年龄、性别等一般资料,先进行单因素分析,获得有统计学差异的项目后再行Logistic回归分析,最终获得影响患者中远期血压下降的独立危险因素。结果术前与术后24h收缩压(SBP)与舒张压(DBP)相比,差异无统计学意义(P>0.05);术后1、6个月,SBP与DBP均低于术前24h,差异有统计学意义(P<0.05);术后6个月,54例患者中共有23例出现收缩压下降≥10mmHg;单因素分析显示:性别、体重指数(BMI)、糖尿病史、吸烟、饮酒史与行CAS治疗患者术后中远期血压降低无关,差异无统计学意义(P>0.05);年龄、术前低血压病史、狭窄程度≥80%、合并未控制的高血压、手术时间>1h与患者中远期血压降低有关,差异有统计学意义(P<0.05);多因素Logistic回归分析显示:年龄≥75岁、术前低血压病史、狭窄程度≥80%、合并未控制的高血压、手术时间>1h是行CAS治疗患者术后中远期血压降低的独立危险因素(P<0.05)。结论经CAS治疗后仍有部分患者出现中远期血压降低,而年龄≥75岁、术前低血压病史、狭窄程度≥80%、合并未控制的高血压、手术时间>1h是造成中远期血压降低的高危因素,临床需予以高度重视,积极采取有效的预防措施,适时调整高血压患者降压方案,以尽可能预防中远期血压过低,改善患者预后。
Objective To investigate the effect of internal carotid artery stenting(CAS)on medium⁃and long⁃term blood pressure and the factors associated with the decline in medium⁃and long⁃term blood pressure.Methods 54 patients treated with CAS in our hospital from December 2020 to December 2021 were selected as the study subjects.Comparing the blood pressure levels of 54 patients in 24 hours before surgery and 24 hours after surgery,1 month after surgery and 6 months after surgery;According to the decline in systolic blood pressure in 6 months after surgery,it was divided into the group with de⁃creased systolic blood pressure(systolic blood pressure drop≥10 mmHg)and the group without systolic blood pressure drop(systolic blood pressure drop<10 mmHg),collected the general data of the age and sex of all patients,first performed one⁃factor analysis,obtained statistically different items and then performed logistic regression analysis,and finally obtained in⁃dependent risk factors affecting the patient′s long⁃term blood pressure decline.Results There was no statistically signifi⁃cant difference between systolic blood pressure(SBP)and diastolic blood pressure(DBP)before and after surgery(P>0.05);SBP and DBP were both lower than 24 hours before surgery at 1 and 6 months postoperatively,and the difference was statistically significant(P<0.05);23 of the 54 patients in 6 months postoperatively had a drop in systolic blood pressure≥10 mmHg;univariate analysis showed:sex,body mass index(BMI),diabetes history,smoking,The difference was not statis⁃tically significant(P>0.05)in the history of alcohol consumption and the decrease in intraoperative and long⁃term blood pressure in patients treated with CAS(P>0.05);age,history of preoperative hypotension,≥degree of stenosis,combined with uncontrolled hypertension,>and 1h of surgery time were associated with the reduction of medium⁃and long⁃term blood pressure in patients(P<0.05);multivariate Logistic regression analysis showed that:age≥75 years,preoperat
作者
邓鹏飞
李递通
陈锦俭
Deng Pengfei;Li Ditong;Chen Jinjian(The Second People′s Hospital,537000 Yulin)
出处
《辽宁医学杂志》
2023年第5期1-4,共4页
Medical Journal of Liaoning
基金
玉林市科学研究与技术开发计划项目(20220641)。
关键词
颈内动脉支架成形术
血压
影响因素
Stenting of the internal carotid artery
Blood pressure
Influencing factors
