冠心病合并轻中度慢性肾脏病患者PCI后支架内再狭窄的相关因素分析  

In-stent restenosis in patients with coronary heart disease and mild-to-moderate chronic kidney disease after PCI:an analysis on related factors

作　　者：吴皓宇[1] 曹怿玮 祁杰[1] 常凤军[1] 汪玲果[1,3] Wu Haoyu;Cao Yiwei;Qi Jie;Chang Fengjun;Wang Lingguo(Department of Cardiovascular Medicine,Shaanxi Provincial People's Hospital,Xi'an 710068,China.)

机构地区：[1]陕西省人民医院心血管内科,西安710068 [2]陕西省人民医院心电图室,西安710068 [3]陕西省人民医院医务处,西安710068

出　　处：《中国循证心血管医学杂志》2022年第1期62-65,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：陕西省自然科学基础研究计划基金资助项目(2020JQ-939);陕西省人民医院2019年科技发展孵化基金资助项目(2019YXQ-08)。

摘　　要：目的分析冠状动脉粥样硬化性心脏病(冠心病)合并轻中度慢性肾脏病患者冠状动脉(冠脉)药物洗脱支架术后支架内再狭窄(ISR)的相关因素。方法选择陕西省人民医院心内科自2015年11月至2018年9月行药物洗脱支架置入且合并轻中度慢性肾脏病的冠心病患者189例,术后9~15月复查冠脉造影后,分为支架术后再狭窄组和无再狭窄组,比较两组临床资料及生化指标等差异。结果平均随访(12.6±2.1)月,ISR发生率20.1%。与无再狭窄组相比,再狭窄组患者主动吸烟史、糖尿病史、家族性心肌梗死史、糖化血红蛋白、低密度脂蛋白胆固醇、估算肾小球滤过率及尿酸水平等差异均具有统计学意义(P<0.05)。多因素Logistic回归方法分析显示,糖尿病、家族性心肌梗死史、糖化血红蛋白、尿酸是ISR的独立危险因素。结论糖尿病、家族性心肌梗死史、糖化血红蛋白、尿酸是冠心病合并轻中度慢性肾脏病患者冠脉药物洗脱支架术后ISR的独立危险因素,对ISR具有一定预测价值。Objective To analyze the related factors of in-stent restenosis(ISR)in patients with coronary heart disease(CHD)and mild to moderate chronic kidney disease after the implantation of coronary drug eluting stent(DES).Methods The patients with CHD and mild-to-moderate chronic kidney disease(n=189)were chosen from Department of Cardiovascular Medicine in People’s Hospital of Shaanxi Province from Nov.2015 to Sept.2018.All patients were given angiography reexamination after the operation for 9 to 15 months,and divided into restenosis group and non-restenosis group.The clinical materials and biochemical indexes were compared between 2 groups.Results All patients were averagely followed up for(12.6±2.1)months,and incidence rate of ISR was 20.1%.The difference in history of active smoking,diabetes history,family history of myocardial infarction,and levels of glycated hemoglobin(HbAlc),low-density lipoprotein-cholesterol(LDL-C),estimated glomerular filtration rate(eGFR)and uric acid(UA)had statistical significance between restenosis group and non-restenosis group(P<0.05).The results of Logistic regression analysis showed that diabetes,family history of myocardial infarction,HbAlc and UA were independent risk factors of ISR.Conclusion Diabetes,family history of myocardial infarction,HbAlc and UA are independent risk factors of ISR after coronary DES implantation,and they have some predictive values to ISR in patients with CHD and mild-to-moderate chronic kidney disease.

关 键 词：冠心病 药物洗脱支架 支架内再狭窄 慢性肾脏病 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]