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目的 探讨椎动脉粥样硬化性狭窄患者血管内支架置入术后再狭窄的危险因素,研究再狭窄患者预后.方法 选择南京鼓楼医院2004-2013年间收治的椎动脉粥样硬化性狭窄患者173例,均行血管内支架置入术,术后随访(55.7±17.31)个月,记录其性别、年龄、合并症、吸烟史、病变部位、术前术后椎动脉直径、支架类型、支架直径、支架长度等,分析血管内支架置入术后再狭窄的危险因素以及再狭窄预后.结果 所有患者顺利完成血管内支架置入术,随访期间28例出现再狭窄,145例未出现再狭窄,再狭窄发生率为16.2％.2组患者性别、年龄、随访时间、糖尿病、高尿酸血症、冠心病、血管直径、支架类型差异均无统计学意义(P＞0.05);而再狭窄组高血压、高脂血症、吸烟、和颅外V1段、颅内V4段支架植入位置均明显高于非再狭窄组(P＜0.05).多因素logistics回归分析显示,高脂血症(HR:4.31,95％CI: 2.99～18.76,P=0.042)为再狭窄危险因素.再狭窄组卒中发生风险明显高于非再狭窄,Kaplan-Meier分析结果显示,再狭窄组卒中终点事件风险高(OR: 0.141,95％CI: 0.016～1.221,P=0.029),差异有统计学意义.结论 椎动脉起始部粥样硬化性狭窄患者血管内支架置入术后再狭窄发生率较高,高脂血症是再狭窄独立危险因素,再狭窄患者发生卒中事件风险高.“,”Objective To investigate the risk factors and restenosis prognosis of restenosis in postoperative patients with atherosclerotic vertebral artery stenosis treated by endovascular stent implantation.Methods A total of 173 patients with atherosclerotic vertebral artery stenosis were selected in the Nanjing Drum Tower Hospital from 2004 to 2013,and all of them were treated by endovascular stent implantation and were followed up for(55.7±17.31).Clinical data including gender,age,complications,smoking history,stent region,preoperative and postoperative diameter of vertebral artery,stent types,stent diameter,stent length and postoperative stenosis length were collected,and the risk factors and restenosis prognosis of restenosis in postoperative patients with atherosclerotic vertebral artery stenosis treated by endovascular stent implantation were analyzed.Results All of the 173 patients successfully completed the endovascular stent implantation,including 28 cases with restenosis,and other 145 cases without restenosis,and the incidence of restenosis was 16.2％.No statistically significant difference of gender,age,time of follow up,incidence of hyperuricemia,diabetes,coronary artey disease,stent diameter,stent types was found between two groups(P＞0.05);positive rate of smoking history,high blood pressure and hyperlipemia and the stent region of restenosis group was statistically significantly higher than that of the control group(P＜0.05);Multivariate logistic regression analysis results showed that hyperlipemia(HR:4.31,95％ CI: 2.99-18.76,P=0.042)was the only risk factor of restenosis in postoperative patients with atherosclerotic vertebral artery stenosis treated by endovascular stent implantation.The results of Kaplan-Meier showed that recurrent ischemic events were associated with in-stent restenosis(OR: 0.141,95％ CI: 0.016-1.221,P=0.029).Conclusion The incidence of restenosis is relatively high in postoperative patients with atherosclerotic vertebral artery stenosis treated by endovascular stent implantation,and hyperlipemia is the risk factor,while recur-rent ischemic events are associated with restenosis.