非酒精性脂肪性肝病与PCI术后支架内再狭窄的相关性研究  

Correlation between non-alcoholic fatty liver disease and in-stent restenosis after percutaneous coronary intervention

作　　者：胡晟 潘庆华 瞿兵 钱成[2] 陈鹏飞[3] Hu Sheng;Pan Qinghua;Qu Bing;Qian Cheng;Chen Pengfei(Department of Gastroenterology,Central Hospital of Enshi Autonomous Prefecture, Enshi 445000, China)

机构地区：[1]恩施土家族苗族自治州民族医院消化内科,恩施445000 [2]武汉大学中南医院心内科,武汉430071 [3]武汉大学中南医院消化内科,武汉430071

出　　处：《中国循证心血管医学杂志》2017年第7期828-830,共3页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨非酒精性脂肪性肝病(NAFLD)与经皮冠状动脉介入治疗(PCI)术后支架内再狭窄(ISR)之间的关系。方法选取2013年1月~2015年12月于恩施土家族苗族自治州民族医院和武汉大学中南医院成功行PCI并于术后1年复查冠状动脉造影的冠心病患者277例,其中男性187例,女性90例,平均年龄为(62.9±8.3)岁。ISR定义为造影所示支架内径狭窄程度≥50%,据此将患者分为ISR组(n=48)和非ISR组(n=229)。收集和分析患者一般临床资料、实验室检查结果、冠状动脉病变和支架置入方面的资料。结果 ISR组患者体质指数、尿酸、低密度脂蛋白胆固醇和2型糖尿病比例明显高于非ISR组,差异具有统计学意义(P均<0.05)。ISR组患者的支架长度大于非ISR组,而支架直径小于非ISR组,差异具有统计学意义(P均<0.05)。Logistic回归分析结果表明,NAFLD(OR=2.34,95%CI:1.25~4.38)、2型糖尿病(OR=2.61,95%CI:1.32~5.18)、血尿酸(OR=1.08,95%CI:1.01~1.16)和支架直径(OR=0.64,95%CI:0.48~0.85)为PCI术后ISR发生的独立影响因素。结论非酒精性脂肪性肝病与PCI术后ISR密切相关,且是ISR的独立危险因素。Objective To discuss the relationship between non-alcoholic fatty liver disease(NAFLD)andin-stent restenosis(ISR)after percutaneous coronary intervention(PCI).Methods The patients with coronaryheart disease(CHD,n=277,male187,female90and average age=62.9±8.3),undergone successful PCI andreceived coronary angiography(CAG)after PCI for1y,were chosen from the Central Hospital of Enshi AutonomousPrefecture and Zhongnan Hospital of Wuhan University from Jan.2013to Dec.2015.When the degree of ISR≥50%,ISR was defined,and according to which all patients were divided into ISR group(n=48)and non-ISR group(n=229).The general clinical data,outcomes of laboratory tests,and data of coronary lesions and stent implantationwere collected and analyzed.Results The levels of body mass index(BMI),uric acid(UA)and low-densitylipoprotein-cholesterol(LDL-C),and percentage of patients with type2diabetes mellitus(T2DM)were significantlyhigher in ISR group than those in non-ISR group(all P<0.05).The length of stent was longer,and diameter ofstent was less in ISR group than those in non-ISR group(all P<0.05).The results of Logistic regression analysisshowed that NAFLD(OR=2.34,95%CI:1.25~4.38),T2DM(R=2.61,95%CI:1.32~5.18),UA(OR=1.08,95%CI:1.01~1.16)and diameter of stent(OR=0.64,95%CI:0.48~0.85)were independent influence factors of ISR after PCI.Conclusion NAFLD is closely correlated to ISR,and it is an independent risk factor of ISR after PCI.

关 键 词：非酒精性脂肪性肝病 冠心病 药物洗脱支架 支架内再狭窄 

分 类 号：R589.2[医药卫生—内分泌]