中文摘要：

目的 明确颈动脉支架术（CAS）后血流动力学损害（HD）情况,分析HD的危险因素,并观察其对术后并发症的影响.方法 196例接受CAS手术的病人按照是否发生低动力学改变分为HD组和非HD组,对HD的发牛率、发生时间、持续时间和严重程度进行观察,并观察各种临床基线特征和血管病变特征对HD的影响;应用Logistic回归分析确立HD的独立危险因素;并观察HD对术后并发症的影响.结果 196例入组病人均为2009年3月至2010年8月在大坪医院神经内科的住院病人,其中有104例发生HD,发生率为53.1%;67.3%的HD发牛于术后1～16 h内;55.8%的HD持续24 h以上,并在3～16 d内缓解;78.9%的HD患者需用药物维持心率和血压.糖尿病、高血压和吸烟病史、斑块累及颈动脉窦部、溃疡性斑块和钙化斑块等因素显示与HD的发生有关.Logistic回归分析提示糖尿病和吸烟为HD的独市保护因素,斑块累及颈动脉窦部和钙化斑块为HD的独立危险因素.HD患者出现神经系统和心肺并发症的风险增高.结论 CAS术后HD的发生率较高,且与术后并发症有关;斑块累及颈动脉窦部和钙化斑块为HD的独立危险因素.

英文摘要：

Objective To investigate the carotid angioplasty and stenting （CAS）.induced hemodynamic depression （HD） and its impact on postprocedural complications so as to identify its risk factors.Methods The incidence,onset time,duration and sevefity of HD were observed in 196 CAS patients.The influences of clinical baseline and vascular angiographic characteristics on HD were recorded and the relationship between HD and postprocedural complications was analyzed.Logistic regression analysis was used to identify the independent risk factors of HD.Results The incidence of HD was 53.1%.Most cases of HD（67.3%）developed within 1-16 hours postprocedural.And 55.8%HD lasted for over 24 hours and became relieved within 3-16 days post-operation.And 78.9% HD patients required medications for the controls of blood pressure and heart rate.Diabetes,hypertension,smoking,plaque involving carotid bulb,ulcerated plaque and calcified plaque were shown to be associated with HD.Further analysis of logistic regression suggested that diabetes and smoking were two protective factors for HD while plaque involving carotid bulb and calcified plaque two independent risk factors for HD.The HD patients were at an increased risk of neurological and cardiopulmonary complications.Conclusion With a high post-CAS incidence after CAS,HD is associated with postprocedural complications.Lesions involving carotid bulb and calcified plaque are two independent risk factors for HD.