脂蛋白α对冠状动脉支架膨胀效果的影响及其危险因素  

Effect of lipoproteinαon coronary stents expansion and its risk factors

作　　者：刘佳佳 曹宇[1] 盛喆 LIU Jiajia;CAO Yu;SHENG Zhe(Department of Cardiology,Third Xiangya Hospital,Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院心内科,长沙410013

出　　处：《中南大学学报（医学版）》2021年第3期249-256,共8页Journal of Central South University ：Medical Science

摘　　要：目的:使用血管内超声检查评价高脂蛋白α血症对冠状动脉支架术后即刻膨胀效果的影响。方法:回顾性收集2019年2月至2019年9月在中南大学湘雅三医院心内科诊断为冠心病并在血管内超声仪指导下置入支架的160例患者(175处病变)信息,且根据脂蛋白α浓度>300 mg/L分为高脂蛋白α血症组和正常对照组。采用超声心动图检测并计算心脏射血分数,采用logistic回归分析高脂蛋白α血症的影响因素;经皮冠状动脉介入术后在靶血管内行血管内超声检查,分析高脂蛋白α血症对冠状动脉支架术后即刻膨胀效果的影响。结果:高脂蛋白α血症组平均支架膨胀指数、病变长度、支架数目、支架对称指数、后扩球囊直径分别为(94.73±18.9)%、(52.92±29.1)mm、(2.11±0.85)个、(83.62±13.07)%、(9.46±2.00)mm,与正常对照组相比差异均有统计学意义(均P<0.05)。Logistic多因素回归分析表明血清肌酐清除率下降是高脂蛋白α血症的独立危险因素(95%CI:0.964~0.997,P<0.05)。结论:高脂蛋白α血症是冠状动脉支架膨胀不良的影响因素,下降的肌酐清除率是高脂蛋白α血症的独立危险因素。Objective:To analyze the effect of hyperlipoproteinemia(α)on immediate expansion after coronary stent implantation guided by intravascular ultrasound(IVUS).Methods:A total of 160 patients(175 lesions)with coronary heart disease diagnosed by coronary artery angiography,who were performed percutaneous intervention guided by IVUS in the Department of Cardiology,Third Xiangya Hospital,Central South University,were enrolled retrospectively.According to the concentration of lipoproteina,the patients were divided into 2 groups:a hyperlipoproteinemia(α)group and a control group.Cardiac ejection fraction was measured with echocardiography.Logistic regression was used to analyze the influential factors for hyperlipoproteinemia(α).The target vessel was examined by IVUS to analyze the immediate expansion effect of hyperlipoproteinemia(α)after stent implantation.Results:The mean stent expansion index,lesion length,stent number,stent symmetry index and posterior balloon diameter were(94.73±18.9)%,(52.92±29.1)mm,(2.11±0.85),(83.62±13.07)%,and(9.46±2.00)mm in the hyperlipoproteinemia(α)group,respectively.Compared with the control group,there were significantly difference(all P<0.05).Multivariable regression analysis showed that the decreased creatinine clearance rate was an independent risk factor for hyperlipoproteinemia(α)(P<0.05).Conclusion:Hyperlipoproteinemia(α)appears to be a predictor of stent underexpansion,and the decreased creatinine clearance rate is an independent risk factor for hyperlipoproteinemia(α).

关 键 词：高脂蛋白α血症 支架膨胀 血管内超声 

分 类 号：R654.3[医药卫生—外科学]