摘要
目的分析颈动脉支架置入术后新发无症状缺血性脑损伤(NSIBL)的危险因素。方法选取湖南中医药大学第一附属医院2022-01—2024-06收治的146例行颈动脉支架置入术患者,根据患者术后2周是否发生NSIBL分为NSIBL组(32例)及非NSIBL组(114例),采用单因素和多因素Logistic回归分析颈动脉支架置入术后NSIBL的危险因素。结果NSIBL组年龄≥60岁占比、入院时收缩压、入院时舒张压、颈动脉狭窄≥90%、术后残余狭窄占比、入院时NIHSS评分、TG、LDL-C、空腹血糖、糖尿病占比均高于非NSIBL组(P<0.05),HDL-C水平低于非NSIBL组(P<0.05)。经Logistic回归分析显示,年龄>60岁、颈动脉完全闭塞占比、术后残余狭窄、入院时NIHSS评分高、TG和LDL-C水平高、空腹血糖水平高、糖尿病是颈动脉支架置入术后NSIBL的危险因素(P<0.05),HDL-C是颈动脉支架置入术后NSIBL的保护因素(P<0.05)。结论颈动脉支架置入术后NSIBL多发于老年人群,其发病危险因素混杂,颈动脉闭塞、术后残余狭窄、糖尿病、入院时神经功能、血脂及血糖均为NSIBL发生的重要危险因素,HDL-C是NSIBL发生的保护因素。
Objective To analyze the risk factors for new silent ischemic brain lesion(NSIBL)after carotid artery stenting.Methods A total of 146 patients with carotid artery stenting admitted to the First Affiliated Hospital of Hunan University of Traditional Chinese Medicine from January 2022 to June 2024 were selected.The patients were divided into the NSIBL group(32 cases)and the non-NSIBL group(114 cases)based on whether NSIBL occurred 2 weeks after the operation.Univariate and multivariate Logistic regression were used to analyze the risk factors for NSIBL after carotid artery stenting.Results Laboratory indexes TG and fasting blood glucose levels were abnormal,higher than the normal range.The proportion of age≥60 years old,systolic blood pressure on admission,diastolic blood pressure on admission,carotid artery stenosis≥90%,residual stenosis,NIHSS score on admission,TG,LDL-C,fasting blood glucose and diabetes in the NSIBL group were higher than those in the non-NSIBL group(P<0.05),the HDL-C level was lower than that of the non-NSIBL group(P<0.05).Logistic regression analysis showed that age>60 years old,total carotid artery occlusion ratio,postoperative residual stenosis,high NIHSS score on admission,high TG,LDL-C levels,high fasting blood glucose and diabetes were risk factors for NSIBL after carotid artery stenting(P<0.05).HDL-C was a protective factor for NSIBL after carotid artery stenting(P<0.05).Conclusion NSIBL after carotid artery stenting is more common in the elderly population.The risk factors for the onset of this disease are mixed.Carotid artery occlusion,postoperative residual stenosis,diabetes,neurological function at admission,blood lipid and blood glucose levels are important risk factors for the occurrence of NSIBL,and HDL-C is a protective factor for the occurrence of NSIBL.
作者
戴意嘉
张茜
张占伟
许时来
康松清
DAI Yijia;ZHANG Qian;ZHANG Zhanwei;XU Shilai;KANG Songqing(The First Affiliated Hospital of Hunan University of Traditional Chinese Medicine,Changsha 410000,China)
出处
《中国实用神经疾病杂志》
2026年第1期58-63,共6页
Chinese Journal of Practical Nervous Diseases
基金
湖南省自然科学基金项目(编号:2025JJ80982)。
