冠心病患者经皮冠状动脉介入治疗后再次冠状动脉血运重建的影响因素分析  

Risk Factors Analysis of Repeat Coronary Revascularization After Percutaneous Coronary Intervention in Patients with Coronary Heart Disease

作　　者：吴淼[1] 蒋学俊[1] 文英[1] 任珊[1] 贺轶宇[1] 

机构地区：[1]武汉大学人民医院心内科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2014年第3期414-417,共4页Medical Journal of Wuhan University

摘　　要：目的:探讨冠心病患者经皮冠状动脉介入治疗(PCI)后再次冠状动脉血运重建的影响因素。方法:回顾性分析冠心病PCI术后患者239例,根据是否进行再次血运重建将其分成再次血运重建组及单次血运重建组,比较两组病史、症状和冠状动脉造影资料,COX回归模型对有差异的因素进行分析。结果:与单次血运重建组比较,再次血运重建组患者吸烟、高血压、糖尿病比例明显升高(P<0.05)。再次血运重建组复发胸痛比例、脂蛋白a[Lp(a)]水平与单次血运重建组相比明显升高(P<0.01)。再次血运重建组的多支病变比例数和未完全血运重建比例数显著高于单次血运重建组(P<0.01)。COX回归分析显示,吸烟(OR=2.139,95%CI:1.157-3.955)、复发胸痛(OR=2.458,95%CI:1.357-4.452)和Lp(a)(OR=1.001,95%CI:1.000-1.002)与PCI术后再次冠状动脉血运重建相关。结论:冠心病患者PCI术后3年随访提示,吸烟、复发胸痛症状和Lp(a)浓度升高是PCI术后再次冠状动脉血运重建的独立危险因素。Objective： To study the factors influencing repeat coronary revascularization after percutane- ous coronary intervention （PCI） in patients with coronary heart disease （CHD）. Methods, A total of 239 CHD cases who underwent coronary angiography after PCI therapy were enrolled, and were divided into two groups as repeat coronary revascularization （RCR） group and single coro- nary revascularization （SCR） group. Their medical records, symptoms, and coronary angiogra- phy data were compared. The influencing factors were analyzed by COX regression analysis. Results, Compared with that respectively in SCR group, the smoking, hypertension, and diabetes rates in RCR group increased （P〈0.05）. There were significant difference between RCR group and SCR group in postoperative chest pain, Lp（a） level, multiple coronary lesion, and incomplete revascularization （P〈0.01）. COX regression analysis showed that the repeat coronary revascu- larization after the first PCI was correlated with smoking （OR=2. 139, 95%CI. 1. 157-3. 955）, recurrent chest pain （OR=2. 458,95% CI：1. 357-4. 452）, and Lp（a） level （OR=1. 001, 95% CI. 1. 000-1. 002）. Conclusion. Three years follow-up of CHD patients after PCI indicates that smoking, recurrent chest pain, and Lp（a） level are independent risk factors for repeat coronary revas cularization in post-PCI patients.

关 键 词：冠心病 药物洗脱支架 经皮冠状动脉介入术 再次冠状动脉血运重建 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]