冠状动脉支架植入术后再狭窄与临床血清学指标的关系探讨  

To Explore the Relationship between Clinical Serum Markers and Intracoronary in-stent Restenosis.

作　　者：王超权[1,2] 徐耕[1] 程刚[1] 王翔[2] 任品芳[2] 

机构地区：[1]浙江大学医学院附属第二医院,浙江杭州310009 [2]中国医科大学绍兴医院,绍兴县中心医院,浙江绍兴312030

出　　处：《心脑血管病防治》2009年第2期84-86,91,共4页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的探讨冠状动脉内药物涂层支架置入术后支架内再狭窄与临床血清学指标的关系。方法214例冠状动脉内药物涂层支架置入术后患者因胸痛再发或常规行冠脉造影随访,以原靶病变管腔直径狭窄≥50%为支架内再狭窄,比较与无狭窄患者的临床血清学指标。结果214例患者共278处病变置入药物涂层支架,支架内再狭窄发生90例(110处病变)。再狭窄占42.1%,与无再狭窄组比较,血脂蛋白a、直接胆红素、谷丙转氨酶、谷草转氨酶、胆碱酯酶、纤维蛋白原等无显著统计学差异;再狭窄组患者血LDL/HDL、总胆汁酸、尿酸、碱性磷酸酶和γ-谷氨酰转移酶水平高于无再狭窄组,总胆红素低于无再狭窄组,均有显著统计学意义(P<0.05)。logistic多因素回归分析结果显示,糖尿病(OR=1.038)、高LDL/HDL(OR=1.542)、高胆汁酸(OR=1.197)、高尿酸(OR=1.113)、长病变(OR=1.331)是再狭窄的危险因素(P<0.05),而高总胆红素(OR=0.891)是再狭窄的保护因素(P<0.05)。结论血总胆红素、总胆汁酸、尿酸、LDL/HDL等临床血清学指标与药物涂层支架术后支架内再狭窄密切相关。Objeetive To explore the relationship between scram markers and coronary in-stent restenosis after drug-during stent implantation. Methods The study enrolled 214 patients who underwent drug-eluting stent implantation and accepted coronary angiography for recurrent chest pain or routine fonow-up. The vascular's diameter stenosis 〉150% was used as a definition of restenosis. Patient's clinical data and risk factors for CHD were collected, and the clinical serum markers were detected. Results Among the 214 patients (278 lesions), restenosis occurred in 90 patients (110 lesions) and the restenosis rote was 42.1%. Compared to non-restenosis group, serum markers such as lipoprotein a, conjugated bilimbin, glutamic pyruvictransaminase, aspartate aminotrans- ferase, cholinesterase and fibrinogen in restenosis group had no significant difference; indexes such as serum LDL/HDL, total bile acid, uric acid, alkaline phesphatase and glutaminoacytransferase levels were higher and serum total bilirubin level was lower in restenosis group than those in non-restenosis group(P 〈 0.05). As a result of multivariate regression analysis, diabetes (OR = 1.038), high serum level of LDL/HDL (OR= 1.542), high total bile acid (OR = 1.197), high urine acid(OR= 1.113)and long lesion(OR = 1.331) were risk factors contributed to restenosis ( P 〈 0.05), while high serum total bilimbin level (OR = 0.891 )was a protecting factor to restenosis( P 〈0.05). Conclusions Some clinical serum markers such as total bilimbin, total bile acid, urine acid, and LDL/HDL level are closely correlated with in-stent restenosis after drug-during stentt implantation in coronary artery.

关 键 词：冠状动脉疾病 药物涂层支架 支架内再狭窄 

分 类 号：R541.4[医药卫生—心血管疾病]