冠状动脉旁路移植术后乳内动脉桥血管病变相关因素分析  

RISK FACTORS OF VASCULAR LESIONS IN INTERNAL MAMMARY ARTERY BRIDGE AFTER CORONARY ARTERY BYPASS GRAFT

作　　者：刘志勇[1] 杨东生[1] 章广玲[2] 张希成[3] 田晓丽[3] 邬鹏宇[1] 郭启仓[1] 霍小菊[1] 蒋守芳[2] 高长青[4] 

机构地区：[1]华北煤炭医学院附属医院胸心外科,河北省唐山市063000 [2]华北煤炭医学院 [3]唐山市截瘫疗养院 [4]中国人民解放军总医院心血管外科全军心脏外科研究所

出　　处：《中国煤炭工业医学杂志》2010年第9期1261-1265,共5页Chinese Journal of Coal Industry Medicine

基　　金：军队杰出中青年基金资助项目(04J017)

摘　　要：目的筛选、分析导致冠状动脉旁路移植术(CABG)后的患者左乳内动脉桥血管闭塞的危险因素。方法选取2002年1月—2006年8月在中国人民解放军总医院心血管外科高长青主刀完成的CABG术后患者共228例。通过64-MSCTA的方法判断CABG术后左乳内动脉桥血管通畅情况,收集患者术前、术中信息和术后资料,对可能导致左乳内动脉桥血管病变的危险因素进行单因素分析后,将筛选后的结果通过Logistic多因素回归分析,找出危险因素。结果术前冠脉造影前降支狭窄百分比、术前冠脉造影弥漫性病变;术前血糖;术前甘油三酯;术中检查靶血管直径;LIMA桥血流;同期室壁瘤手术为单因素危险因素,Logistic多因素回归分析,显示LIMA桥病变的危险因素是靶血管的狭窄程度和LIMA桥血流量。结论 LIMA桥通畅率和靶血管狭窄程度、桥血流相关。Objective To approach the risk factors correlated with left internal mammary artery （ LIMA ） occlusion after coronary artery bypass graft （ CABG ）. Methods 228 patients with CABG surgery carried by Prof. Gao Chang-qing in the PLA General Hospital from Jan 2002 to Aug 2006 was included in the study. 64-MSCTA was used to evaluate the lMA grafts lesion post CABG. The risk factors including pre-operation,on-operation and post-operation data were collected and analyzed for the mono-factor analysis,and then sieved,the factors left were analyzed by Logistic regress analysis,and the true factors affecting the grafts occlusion were searched out. Results Mono-factor analysis showed that the risk factors related to LIMA lesion were degree of the stenosed LAD,diffused coronary artery disease,pre-operative blood glucose,the diameter of the target vessel,LIMA Flow,LVA surgery simultaneously with CABG. Logistic regress analysis told us that diffused coronary artery disease,pre-PCI and post-operative TC blood level were risk factors. Conclusion The risk factors relative to LIMA grafts lesion include stenotic degree of target vessel and LIMA flow.

关 键 词：冠状动脉旁路移植术 乳内动脉桥 血管造影 血管病变 相关因素 

分 类 号：R473.6[医药卫生—护理学]