不稳定型心绞痛患者冠状动脉侧支循环形成的预测因素研究  

Predictive factors for the formation of a well-developed coronary collateral circulation in patients with unstable angina pectoris

作　　者：刘瑾春 郑秀花[1] 李宁[2] 张瑞霞[1] 张海柱 Liu Jinchun;Zheng Xiuhua;Li Ning;Zhang Ruixia;Zhang Haizhu(Staff Room of Internal Medicine,Department of Nursing,Henan Vocational College of Nursing,Anyang 455000,Henan Province,China;Department of Rehabilitation Medicine,The Affiliated Hospital of Henan Academy of Chinese Medicine,Zhengzhou 455003,China;Heart Center,Anyang People Hospital,Anyang 455000,Henan Province,China)

机构地区：[1]河南护理职业学院护理系内科教研室,河南安阳455000 [2]河南省中医药研究院附属医院康复医学科,郑州450003 [3]河南省安阳市人民医院心内科,河南安阳455000

出　　处：《首都医科大学学报》2021年第4期642-646,共5页Journal of Capital Medical University

基　　金：河南省科技攻关计划资助项目(201602369)。

摘　　要：目的探讨不稳定型心绞痛患者冠状动脉侧支循环(coronary collateral circulation,CCC)的相关预测因素。方法连续入选和评估207名不稳定型心绞痛患者。根据血管造影侧支循环的发育情况分为2组:侧支循环良好组(75例)和侧支循环发育不良组(132例),比较两组患者临床指标的差异,采用单因素和多因素Logistic回归分析对差异显著因子对CCC的预测价值进行检验。结果糖尿病史、病史时间、罪犯血管血流TIMI分级、多支病变和冠状动脉钙化在两组相比差异有统计学意义(P≤0.05)。单因素和多因素Logistic回归分析对CCC的预测进行检验,在单变量模型中P≤0.10水平上显著的因素被纳入到多元Logistic回归模型中,显示罪犯血管血流TIMI分级≤2级和冠状动脉钙化是良好CCC形成的独立预测因子。结论血管TIMI血流分级≤2级和冠状动脉钙化是CCC的独立预测因子。Objective To investigate the predictive values of factors associated with the development of the coronary collateral circulation(CCC)in patients with unstable angina pectoris.Methods We evaluated 207 consecutive patients who had unstable angina pectoris and were performed coronary angiography.General information and clinical data were recorded.Patients were divided into two groups according to whether their angiographic CCC was well or poorly developed,according to Rentrop’s classification.The differences of the above factors between the two groups were compared,and the predictive values of the factors with significant differences were tested by univariate and multivariate Logistic regression analysis.Results There were significant differences in the factors including diabetes history,time of disease history,TIMI grade,multiple diseased coronary vessels and coronary calcification between the two groups(P<0.05).Univariate and multivariate Logistic regression analysis were used to test their predictive values for good CCC.Significant factors at the level of P≤0.10 in the univariate logistic regression analysis were included in the multiple Logistic regression model,showing that TIMI grade of culprit vessel≤2 and coronary calcification were independently predictive factors for good CCC.Conclusion TIMI grade of culprit vessel≤2 and coronary calcification were independently associated with the development of the CCC.

关 键 词：冠状动脉粥样硬化性心脏病 侧支循环 不稳定型心绞痛 冠状动脉钙化 

分 类 号：R54[医药卫生—心血管疾病]