冠状动脉介入术后再狭窄的影响因素研究  

Influencing Factors of Restenosis After Percutaneous Coronary Intervention

作　　者：郑俊晨[1] 马晓媛[1] 高波[1] 王营忠[1] 

机构地区：[1]延安大学附属医院,陕西省延安市716000

出　　处：《实用心脑肺血管病杂志》2016年第2期16-19,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探讨冠状动脉介入术后再狭窄的影响因素。方法选择2010年3月—2014年2月延安大学附属医院心内科收治的冠状动脉严重狭窄患者70例,均成功行冠状动脉介入术,且在本院完成术后1年的冠状动脉造影复查。根据复查结果将患者分为观察组(支架置入段血管内径狭窄≥50%)和对照组(支架置入段血管内径狭窄<50%),各35例。收集两组患者的性别、年龄、吸烟情况、基础疾病(高血压、糖尿病、高脂血症)、心脏彩超结果〔左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)〕、血生化指标(红细胞计数、白细胞计数、血小板计数)、纤维蛋白原、术前冠状动脉狭窄程度、病变部位〔左主干(LM)、左前降支(LAD)、左回旋支(LCX)、右冠状动脉(RCA)及冠状动脉主干开口〕、球囊压力、支架长度、重叠支架置入情况、支架类型(雷帕霉素洗脱支架和紫杉醇洗脱支架),冠状动脉介入术后再狭窄的影响因素分析采用多因素logistic回归分析。结果观察组患者吸烟率、糖尿病发生率、白细胞计数、重叠支架置入率高于对照组(P<0.05);两组患者性别、年龄、高血压发生率、高脂血症发生率、LVEF、LVEDD、红细胞计数、血小板计数、纤维蛋白原、术前冠状动脉狭窄程度、病变部位、球囊压力、支架长度、支架类型比较,差异无统计学意义(P>0.05)。多因素logistic回归分析结果显示,吸烟〔OR=2.265,95%CI(1.326,4.152)〕、糖尿病〔OR=2.344,95%CI(1.352,4.617)〕、病变部位为冠状动脉主干开口〔OR=1.511,95%CI(1.031,5.015)〕、置入重叠支架〔OR=1.526,95%CI(1.033,3.876)〕是冠状动脉介入术后再狭窄的危险因素(P<0.05)。结论吸烟、糖尿病、病变部位为冠状动脉主干开口、置入重叠支架是冠状动脉介入术后再狭窄的危险因素。Objective To explore the influencing factors of restenosis after percutaneous coronary intervention.Methods From March 2010 to February 2014,a total of 70 patients with severe stenosis of coronary artery were selected in the Affiliated Hospital of Yan＇an University,all of them were successfully treated by percutaneous coronary intervention and received coronary angiography reexamination after 1 year. According to coronary angiography reexamination results,all of the patients were divided into control group（ with stent- implanted vessel stenosis rate less than 50%） and observation group（ with stent-implanted vessel stenosis rate equal or over 50%）,each of 35 cases. Gender,age,smoking status,underlying disease（ such as hypertension,diabetes and hyperlipidaemia）,cardiac color ultrasound examination results（ including LVEF and LVEDD）,serum biochemical index（ including RBC, WBC and PLT）, fibrinogen, preoperative degree of coronary artery stenosis,diseased regions（ including left main coronary artery, left anterior descending branch, left circumflex artery, right coronary artery and open mouth of main coronary artery）, balloon pressure, stent length, overlapping stents usage and stent types（ including sirolimus- eluting stent and paclitaxel- eluting stent） were compared between the two groups,and multivariate logistic regression analysis was used to analyzed the influencing factors of restenosis after percutaneous coronary intervention.Results Smoking rate,positive rate of diabetes history,WBC and usingrate of overlapping stents of observation group were statistically significantly higher than those of control group（ P〈0. 05）,while no statistically significant differences of gender,age,positive rate of hypertension or hyperlipidaemia, LVEF or LVEDD, RBC or PLT, fibrinogen, preoperative degree of coronary artery stenosis,diseased regions,balloon pressure,stent length or stent types was found between the two groups（ P〉0. 05）. Multivariate logistic regression analysis showed that,

关 键 词：血管成形术 气囊 冠状动脉 冠状动脉再狭窄 影响因素分析 

分 类 号：R654.3[医药卫生—外科学]