| Objective:Adopting retrospective research methods,to investigate the correlation between biochemical indexes and internal carotid artery in patients with in stent restenosis,through the analysis of risk factors,exploring the major risk factors,and determining the value of these factors to predict ISR,provideing the basis for clinical diagnosis and treatment.Method:A retrospective analysis from January 2013 to January 2016 in the third hospital of Datong DSA diagnosed intracranial vascular stenosis in 83 patients with concurrent CAS,regularly by CDU、CTA or DSA followed up 3,6,9 months,1-3 years.83 stents were implanted in patients,aged 35~80 years old(58.95 ± 9.09),including 65 cases of male,female 18 cases.According to the result of follow-up follow-up were divided into restenosis group 12 cases,71 cases in non restenosis group.Clinical observation indexes include: the clinical data of patients with temporary inspection,a total of 22 biochemical factors.Univariate and multivariate logistic regression were used to analyze the correlation between these factors and ISR.Finally,the predictive value of related factors on ISR was analyzed by ROC curve.Result:In 83 patients,12 patients with restenosis and restenosis rate 14.5%.Univariate analysis showed that:(1)restenosis group and non restenosis group in age,gender,hypertension,hyperlipidemia,stroke,coronary heart disease,total cholesterol,triglyceride,high density lipoprotein,low density lipoprotein,load apolipoprotein A,postoperative fibrinogen,fibrinogen difference,postoperative white blood cells,white blood cell difference,compare the neutrophil percentage difference,the difference was not statistically significant(P>0.05);(2)Compared with non restenosis group,restenosis group significantly higher proportion of patients with diabetes(66.7%vs19.7%,P = 0.002);the total bilirubin level significantly higher [(9.27±1.56)vs(11.00±4.10),P=0.030];postoperative fibrinogen significantly increased [(5.13±1.46)vs(3.75±0.78),P=0.008];fibrinogen difference [(2.08±1.50)vs(0.93±0.76),P=0.024];white blood cells increased significantly after [(9.52±1.48)vs(8.23±2.44),P=0.020];white blood cell difference [(2.28±1.48)vs(0.95±2.18),P=0.047];neutrophil percentage difference [(10.79±10.06)vs(5.40±8.00),P=0.041].According to whether the occurrence of restenosis as the dependent variable,with diabetes,total bilirubin,postoperative fibrinogen,postoperative white blood cells,white blood cell difference,neutrophil difference as independent variables,multivariate logistic regression analysis showed that diabetes,total bilirubin,postoperative fibrinogen,neutrophil difference is included in the regression equation,the total bilirubin [OR(95%CI):0.379(0.149-0.964);P=0.042] is a protective factor for;diabetes mellitus [OR(95%CI):9.644(1.177-79.051);P=0.035],fibrin after operation [OR(95%CI):5.166(1.315-20.303);P=0.019];neutrophil difference [OR(95%CI):1.225(1.030-1.457);P=0.022],are independent risk factors for ISR.(3)the ROC curve analysis:postoperative FIB,NEUT% difference and combined predictors of area under the ROC curve was 0.795(95%CI:0.643-0.946;P=0.001);0.656(95%CI:0.491-0.820;P=0.086);0.883(95%CI:0.794-0.971;P<0.001).FIB after operation and combined predictors can better predict ISR occurrence,the value of combined predictors of higher diagnosis.Conclusion:The internal carotid artery restenosis rate was 14.5%.Multivariate logistic regression analysis showed that history of diabetes,the levels of TBIL,FIB after operation,the difference of NEUT associated with ISR.The total bilirubin level is a protective factor for ISR;diabetes mellitus,postoperative fibrinogen,neutrophil difference is a independent risk factors of ISR.the postoperative FIB and combined predictors can better predict ISR occurrence,the value of combined predictor is higher. |
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