【摘要】 目的 探讨严重钙化病变对下肢动脉硬化闭塞症(arteriosclerosis obliterans,ASO)腔内治疗后患者死亡风险、再狭窄及再干预的影响。方法 回顾性研究2015年6月至2023年2月在北京大学人民医院行腔内治疗的379例下肢ASO患者的临床和影像学资料，其中重度钙化组142例，非重度钙化组237例，观察分析患者术后2年内死亡、再狭窄、再干预及包括死亡、截肢、再干预在内的复合终点情况。结果 相比非重度钙化患者，重度钙化患者术后2年的再狭窄率(P=0.012)、再干预率(P<0.001)及复合终点率(P=0.001)更高，差异有统计学意义。在对其他变量进行校正之后，重度钙化相对于非重度钙化全因死亡和心脑血管死亡的风险比(hazard ratio,HR)分别为1.36和2.18，但差异无统计学意义(P>0.05)。重度钙化是再狭窄[HR=1.85,95%置信区间(confidence interval,CI)=1.29～2.67,P<0.001]、再干预(HR=2.79,95%CI=1.61～4.84,P<0.001)的独立风险因素。结论 重度钙化会显著增加下肢ASO腔内治疗术后再狭窄、再干预风险，对死亡风险的影响还有待进一步验证。更多还原

【Abstract】 Objective To investigate the effect of severe calcified lesions on the risk of death,restenosis,and reintervention in patients with arteriosclerosis obliterans (ASO) of lower extremities after endovascular treatment.Methods The clinical and imaging data of 379 patients with ASO of lower extremities who underwent endovascular treatment at Peking University People’s Hospital from June 2015 to February 2023 were analyzed retrospectively.Among them,142 patients were in the severe calcification group and 237 in the non-severe calcification group.The outcomes including death,restenosis,reintervention and composite endpoints (death,amputation and reintervention) were observed and analyzed within 2 years after surgery.Results Compared with patients with non-severe calcification,those with severe calcification had significantly higher 2-year post-operative restenosis rate (P=0.012),reintervention rate (P<0.001) and composite endpoint rate (P=0.001),with statistically significant differences.After adjusting for other variables,the hazard ratios (HR) of severe calcification for all-cause mortality and cardiovascular-cerebrovascular mortality were 1.36 and 2.18 vs non-severe calcification,respectively,but the differences were not statistically significant (P>0.05).Severe calcification was an independent risk factor for restenosis[HR=1.85,95%confidence interval (CI)=1.29-2.67,P<0.001]and reintervention (HR=2.79,95%CI=1.61-4.84,P<0.001).Conclusion Severe calcification significantly increases the risks of restenosis and reintervention after endovascular treatment for ASO of lower extremities,while its impact on the risk of death requires further verification.更多还原