中文摘要：

目的探讨椎动脉起始部狭窄支架置入术后再狭窄的危险因素。方法回顾性分析54例椎动脉起始部支架置入术后患者的临床资料,经TCD、颈动脉超声及DSA随访1年,根据是否出现再狭窄,分为再狭窄组（21例）和未狭窄组（33例）。分析椎动脉起始部支架置入后,再狭窄与是否规范抗血小板聚集治疗、支架类型、高血压、糖尿病等因素的相关性。结果支架置入后再狭窄组和未狭窄组患者中,不规范抗血小板聚集治疗出现再狭窄分别为16和6例,χ^2=17.887,P=0.000;吸烟为9和5例,χ^2=5.129,P=0.024。置入裸支架为19和19例,χ^2=6.620,P=0.010;性别、支架位置、支架突出锁骨下动脉长度、血脂、血糖、血压水平、狭窄段长度,两组比较差异均无统计学意义,均P〉0.05。Logistic回归分析提示,支架类型（95%CI：1.936～35.997,OR=8.426,P=0.0045）和规范抗血小板聚集治疗（95%CI：1.341～18.304,OR=1.6883,P=0.0233）与椎动脉起始部狭窄支架置入术后,再狭窄密切相关。结论椎动脉起始部狭窄支架置入术后再狭窄与是否规范抗血小板聚集治疗及置入支架的类型关系密切,其他相关因素有待进一步研究。

英文摘要：

Objective To investigate the risk factors of influencing vertebral artery origin stenosis were treated with stent implantation, among them,33 patients occurred restenosis, the risk factors of restenosis. Methods Fifty-tour patients with vertebral artery origin stenosis were treated with stent implantation, among them,33 patients occurred restenosis,the risk factors of restenosis were analyzed retrospectively. The patients were followed up for one year by transerauial Doppler sonography （TCD） , carotid ultrasonography and digital subtraction angiography （DSA）. The patients were divided into restenosis group （n = 21 ） and normal group （n = 33 ）. The relationship between restenosis after stent implantation and antiplatelet therapy, types of stent, hypertesion and diabetes mellitus were analyzed statistically. Results In the restenosis group and the normal group , the nmnber of patients accepted non-standard antiplatelet treatment were 16 and 6 （ X^2 = 17. 887 ,P = 0.000） ,the number of cigarette smoker were 9 and 5 （X^2 = 5. 129, P = 0.024 ） , and the nmnber of patients used bare stenting were 19 and 19（X^2 = 6. 620,P = 0. 010）. There were significant differences between the two groups（P 〈 0.05 all ）. As compared with the normal group, there were no significant differenees about the sex, stent position, length of stent protruding in the subclavian artery, levels of blood lipid, glucose, blood pressure, length of＇ stenotie segment （ P 〉 0.05 all ）. Logistic regression suggested that the types of stent （ OR = 8. 426, P = 0.0045 ） and the standard antiplatelet therapy （ OR = 1. 6883, P = 0.0233 ） were closely correlated with restenosis after stent implantation. Conclusion Vertebral ＇artery origin restenosis after stent implantation is closely correlated with antiplatelet therapy and the types of stent, the other related factors still remain to be further studied.