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作 者:韩雅玲[1] 刘海伟[1] 张振刚[2] 苗志林[1] 荆全民[1] 王守力[1] 王冬梅[1] 佟铭[1]
机构地区:[1]沈阳军区总医院心内科,沈阳110016 [2]大连医科大学附属第二医院急诊科
出 处:《中国实用内科杂志》2002年第4期209-211,共3页Chinese Journal of Practical Internal Medicine
摘 要:目的 探讨冠状动脉支架内再狭窄与临床因素的关系。方法 前瞻性选择了冠心病易患因素、靶病变长度、支架术后管腔最小直径等 17项观察指标 ,对成功置入冠状动脉内支架 (coronarystent ,CS)并进行冠状动脉造影随访的 81例病人 (10 6条靶血管、12 2枚支架 )进行临床资料分析。单因素和多因素回归分析上述各种临床因素与再狭窄的关系。结果 81例中有 2 7例病人的 33处原支架内发生再狭窄 ,靶病变再狭窄率为 2 7 0 %(33/ 12 2 )。单因素分析发现 :再狭窄组病人中空腹血清胰岛素 >15 μU·mL-1、血管病变长度≥ 15mm、支架术后管腔最小直径 <3 0mm者的比率明显高于无再狭窄组 (分别为 5 9 3%、33 3% ,P <0 0 5 ;6 3 6 %、38 2 % ,P <0 0 5 ;5 4 5 %、2 9 2 % ,P <0 0 1)。多元Logistic回归分析发现 :支架术后管腔最小直径 <3 0mm、靶病变长度≥15mm、空腹血清胰岛素 >15 μU·mL-1是CS术后再狭窄的独立危险因素。结论 较小的支架术后管腔最小直径、过长的靶病变、高胰岛素血症是CS术后再狭窄的最重要的独立危险因素。Objectives To investigate the relationship between post-stenting coronary restenosis and various kinds of clinical factors. Methods Seventeen factors including coronary heart disease risk factors, target lesion length, post-stenting minimal lesion diameter(MLD), etc. were prospectively chosen from 81 patients with 106 target lesion vessels and 122 stents who had successfully undergone coronary stent implantation and performed a follow-up angiography, and then the data was analyzed using univariate and multivariate regression analysis. Results Among 81 patients, 33 stents from 27 patients had demonstrated restenosis angiographically. The in-stent restenosis rate is 27 0% (33/122). Univariate analysis revealed that the percentages of fasting insulin>15μU·mL -1 , target lesion length≥15mm, MLD <3 0mm in restenosis group were higher than non-restenosis group(59 3% vs 33 3%, P<0 05; 63 6% vs 38 2%, P<0 05; 54 5% vs 29 2%, P<0 01, respectively). Multivariate Logistic analysis demonstrated that MLD<3 0mm , target lesion length≥15mm and fasting insulin>15μU·mL -1 were independent risk factors for post-stenting restenosis. Conclusion Smaller MLD after stenting, longer target lesion and hyperinsulinemia are the most important independent risk factors for coronary post-stenting restenosis.
分 类 号:R543.3[医药卫生—心血管疾病]
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