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经皮腔内肾动脉支架置入术后双功能超声对支架内再狭窄的预测价值:倾向评分匹配分析。

Predictive Value of Duplex Ultrasound for Significant In-Stent Restenosis after Percutaneous Transluminal Renal Artery Stent Placement: A Propensity Score Matching Analysis.

机构信息

Department of Medical Ultrasonics, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China; Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.

Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Ultrasound Med Biol. 2019 Apr;45(4):913-920. doi: 10.1016/j.ultrasmedbio.2018.11.009. Epub 2019 Jan 14.

Abstract

To evaluate the value of pre-stenting and early post-stenting (<1 mo) duplex ultrasound parameters in predicting significant in-stent restenosis (ISR), we matched significant ISR patients 1:1 with controls without ISR in pre-stenting and early post-stenting (<1 mo) periods, respectively, using propensity score matching. Duplex ultrasound parameters, such as renal length difference between non-lesion side and lesion side within patient, trans-lesion peak systolic velocity and renal aortic ratio, were compared between cases and controls, and the area under the receiver operating characteristic curve (AUROC) was charted to predict ISR. After propensity score matching, 28 cases were matched in the pre-stenting period and 16 cases in the early post-stenting time period. Pre-stenting renal length difference, early post-stenting peak systolic velocity and renal aortic ratio showed significant differences in case-control comparisons. Early post-stenting peak systolic velocity (AUROC: 0.826, cutoff: 141 cm/s) and renal aortic ratio (AUROC: 0.770, cutoff: 1.75) performed well in predicting significant ISR and may serve as non-invasive markers in ISR surveillance.

摘要

为了评估支架置入前和支架置入后早期(<1 个月)双功能超声参数在预测支架内再狭窄(ISR)方面的价值,我们分别使用倾向评分匹配,将支架置入前和支架置入后早期(<1 个月)的有意义 ISR 患者与无 ISR 患者进行 1:1 匹配。比较了病例组和对照组之间的双功能超声参数,如患者内非病变侧和病变侧的肾长度差异、跨病变收缩期峰值速度和肾主动脉比,并绘制了受试者工作特征曲线(AUROC)以预测 ISR。在倾向评分匹配后,支架置入前有 28 例病例与对照匹配,支架置入后早期有 16 例病例与对照匹配。支架置入前的肾长度差异、支架置入后早期的收缩期峰值速度和肾主动脉比在病例对照比较中存在显著差异。支架置入后早期的收缩期峰值速度(AUROC:0.826,临界值:141cm/s)和肾主动脉比(AUROC:0.770,临界值:1.75)在预测显著 ISR 方面表现良好,可作为 ISR 监测的非侵入性标志物。

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