经皮冠状动脉介入治疗术后支架内再狭窄的多因素Logistic回归分析  

Multiple-factors Logistic regression analysis of in-stent restenosis after percutaneous coronary intervention

作　　者：刘征[1] 于卫国[1] 张蕾[1] 陈金良[1] 李海军[1] 张福利[1] 高翊森 

机构地区：[1]北京军区北戴河疗养院,秦皇岛066100

出　　处：《中国循证心血管医学杂志》2016年第3期317-319,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的 分析经皮冠状动脉介入治疗（PCI）术后出现支架内再狭窄的危险因素,为预防支架内再狭窄提供理论依据。方法 回顾性分析2010年3月~2015年1月于北京军区北戴河疗养院就诊的PCI术后疑似冠状动脉再狭窄的患者126例的资料,其中男性87例,女性39例,平均年龄（57.2±9.8）岁。依据冠状动脉造影结果分为再狭窄组（n=36）和对照组（n=90）。所有患者均行冠状动脉造影术,计算冠状动脉Gensini积分,检测两组低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、总胆固醇（TC）、三酰甘油（TG）、空腹血糖（FPG）和葡萄糖耐量试验（OGTT）等指标。结果 与对照组比较,再狭窄组男性、吸烟、高血压、糖尿病比例,冠状动脉Gensini积分,TG、TC、LDL-C水平,支架长度和支架数量均增加,HDL-C水平和支架直径降低,差异有统计学意义（P均〈0.05）。糖尿病（OR=7.130,95%CI：1.680~12.754）、术后吸烟（OR=2.419,95%CI：1.013~6.215）、冠状动脉Gensini积分（OR=10.537,95%CI：3.678~18.845）、支架长度（OR=1.593,95%CI：1.072~2.393）和支架数量（OR=2.541,95%CI：1.169~3.745）是PCI术后支架内再狭窄的独立危险因素。支架直径（OR=0.659,95%CI：0.485~0.873）是PCI术后支架内再狭窄的保护因素。结论 糖尿病、吸烟、冠状动脉Gensini积分、支架长度和数量是PCI术后支架内再狭窄的独立危险因素,而较大的支架直径则是保护因素。Objective To analyze the risk factors of in-stent restenosis after percutaneons coronary intervention （PCI）, and provide the theoretical evidence for preventing in-stent restenosis. Methods The data of patients with suspected coronary restenosis （n=126, male 87, female 39 and average age=57.2 ± 9.8） was analyzed retrospectively from Mar. 2010 to Jan. 2015. All patients were divided into restenosis group （n=36） and control group （n=90） according to outcomes of coronary angiography （CAG）. The Gensini integrals were calculated, and indexes of LDL-C, HDL-C, TC, TG, fasting plasma glucose （FPG） and oral glucose tolerance test （OGTT） were detected in 2 groups after CAG. Results Compared with control group, the percentage of male and smoking patients, and those with hypertension and diabetes, coronary Gensini integrals, TC, TG, LDL-C, stent length and stent number increased, and level of HDL-C and stent diameter decreased in restenosis group （all P〈0.05）. Diabetes （OR=7.130, 95%CI： 1.680-12.754）, smoking after PCI （OR=2.419, 95%CI： 1.013-6.215）, coronary Gensini integrals （OR=10.537, 95%CI： 3.678-18.845）, stent length （OR=1.593, 95%CI： 1.072-2.393） and stent number （OR=2.541, 95%CI： 1.169-3.745） were independent risk factors of in-stent restenosis after PCI. The stent diameter （0R=0.659, 95%CI： 0.485-0.873） was a protective factor of in-stent restenosis after PCI. Conclusion Diabetes, smoking, coronary Gensini integrals, stent length and stent number are independent risk factors of in- stent restenosis after PCI, and longer stent diameter is a protective factor.

关 键 词：冠状动脉 支架内再狭窄 冠状动脉造影术 危险因素 

分 类 号：R816.2[医药卫生—放射医学]