老年冠心病患者PCI术后发生冠状动脉微循环损伤的影响因素  

Influencing factors of coronary microcirculation injury after PCI in elderly patients with coronary heart disease

作　　者：张都生 吴志勇[1] 林锋[1] 陈威[1] 许锦鸿 郭延松[1] ZHANG Dusheng;WU Zhiyong;LIN Feng;CHEN Wei;XU Jinhong;GUO Yansong(Shengli Clinical College of Fujian Medical University/Fujian Provincial Hospital,Fuzhou 350001,China)

机构地区：[1]福建医科大学省立临床医学院/福建省立医院,福建福州350001

出　　处：《山东医药》2020年第33期31-34,共4页Shandong Medical Journal

基　　金：福建省自然科学基金资助项目(2018J01242)。

摘　　要：目的总结老年冠心病患者经皮冠脉介入(PCI)术后发生冠状动脉微循环损伤的影响因素。方法老年冠心病患者319例,进行PCI手术治疗后,根据术后是否发生冠状动脉微循环损伤分为损伤组(191例)和对照组(128例),收集并比较两组患者的性别、年龄、吸烟史、饮酒史、糖尿病史、高血压病史、高脂血症病史、既往脑卒中病史、既往心肌梗死病史、既往周围血管病史等一般资料,空腹血糖(FPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、左心室射血分数(LVEF)等实验室检查指标,梗死动脉、冠脉病变长度、冠脉狭窄率、人均植入支架数目、支架长度、支架直径、支架扩张压力、预扩张球囊直径、预扩张次数、预扩张时间、术中收缩压等PCI手术相关指标。采用Logistic回归分析法分析老年冠心病患者PCI术后发生冠状动脉微循环损伤的影响因素。结果损伤组女性比例、有吸烟史、糖尿病史、高血压史、既往心肌梗死病史、既往周围血管病史、HbA1c、冠脉病变长度、冠脉狭窄率、支架扩张压力、预扩张次数、预扩张时间、LVEF、术中收缩压等资料与对照组相比,P均<0.05。女性、糖尿病史、高血压史、既往心肌梗死病史、预扩张时间是老年冠心病患者PCI术后发生冠状动脉微循环损伤的影响因素。结论老年冠心病患者PCI术后可能发生冠状动脉微循环损伤,女性、糖尿病史、高血压史、既往心肌梗死病史、预扩张时间长是其危险因素。Objective To summarize the influencing factors of coronary micro-circulation injury(CMI)after percutaneous coronary intervention(PCI)in elderly patients with coronary heart disease.Methods A total of 319 patients receiving PCI were divided into the observation group(191 cases with CMI)and the control group(128 cases without CMI),respectively.The clinical data,including sex,age,cigarette smoking,and alcohol intaking,hypertension,diabetes,hyperlipidemia,previous history of stroke,myocardial infarction and peripheral vessels disease,etc.were compared between the two groups as well as the experimental indexes,including the fasting plasma glucose(FPG),glycosylated hemoglobin(Hb A1 c),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),left ventricular ejection fraction(LVEF),and the operation correlative factors of PCI,including coronary lesion length,coronary artery stenosis,stent dilation pressure,times of balloon pre-dilation,balloon pre-dilation time,intraoperative systolic blood pressure,etc.Logistic regression analysis was used to analyze the risk factors of CMI after PCI in elderly patients with coronary heart disease.Results Statistically significant differences were found in the proportion of female,cigarette smoking,diabetes,hypertension,previous infarction,previous peripheral vessels disease,Hb A1 c,coronary lesion length,coronary artery stenosis,stent dilation pressure,times of balloon pre-dilation,balloon pre-dilation time,LVEF,and intraoperative systolic blood pressure between these two groups(all P<0.05).By multivariate logistic regression analysis,female,diabetes,hypertension,previous myocardial infarction,and balloon pre-dilation time were independent risk factors for coronary micro-circulation injury in patients with coronary heart disease(all P<0.05).Conclusion The coronary microcirculation injury occurs in elderly patients with coronary heart disease after PCI;female,diabetes,hypertension,previous myocardial infarction,and ba

关 键 词：冠心病 经皮冠脉介入术 冠状动脉微循环损伤 

分 类 号：R543.3[医药卫生—心血管疾病]