早发与晚发冠心病患者支架内再狭窄的临床特点及危险因素差异分析  

Analysis of Clinical Characteristics and Risk Factors of In-stent Restenosis in Patients with Premature and Mature Coronary Heart Disease

作　　者：程铿 孙敏妮 李风祥 孙国举[1] CHENG Keng;SUN Minni;LI Fengxiang;SUN Guoju(Department of Cardiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院心血管内科,河南郑州450052

出　　处：《河南医学研究》2022年第5期807-811,共5页Henan Medical Research

摘　　要：目的探讨早发和晚发冠心病患者发生支架内再狭窄(ISR)的临床特点及危险因素差异。方法收集2018年1月至2019年12月在郑州大学第一附属医院接受经皮冠状动脉介入(PCI)术治疗的972例冠心病患者的手术资料及临床资料,根据有无ISR及NECP-ATPⅢ规定分为ISR组102例、非ISR组870例,其中早发冠心病组492例(ISR组50例、非ISR组442例),晚发冠心病组480例(ISR组52例、非ISR组428例),分析早发与晚发冠心病患者支架内再狭窄的临床特点及危险因素差异。结果ISR组患者高血压、糖尿病、冠心病家族史比例、糖化血红蛋白(HbA1c)水平、低密度脂蛋白胆固醇(LDL-C)水平、多支病变比例、支架数及总支架长度较非ISR组高,高密度脂蛋白胆固醇(HDL-C)水平较非ISR组低(P<0.05);早发ISR组吸烟比例、冠心病家族史比例、LDL-C水平、多支病变比例、支架数及总支架长度较非ISR组高,HDL-C水平较非ISR组低(P<0.05);晚发ISR组高血压、糖尿病比例、HbA1c水平、多支病变比例、支架数及总支架长度较非ISR组高,支架直径较非ISR组小(P<0.05)。多因素logistic回归分析显示,总体患者中冠心病家族史、HbA1c、LDL-C、总支架长度是ISR的独立危险因素,早发组中冠心病家族史、LDL-C、总支架长度是ISR的独立危险因素;晚发组中高血压、糖尿病、HbA1c、总支架长度、支架直径是ISR的独立危险因素。结论不同年龄人群发生ISR的危险因素存在差异,早发冠心病ISR患者具有更多的冠心病家族史和更高的LDL-C水平,晚发冠心病ISR患者存在更多的高血糖、高血压以及更小的靶病变血管。更多更长的支架植入会增加所有冠心病患者发生ISR的风险。Objective To explore the clinical characteristics and risk factor differences in-stent restenosis(ISR)in patients with premature and mature coronary heart disease.Methods The surgical and clinical data of 972 patients received percutaneous coronary intervention(PCI)from January 2018 to December 2019 were collected.According to whether ISR and NECP-ATPⅢregulations,102 patients were divided into ISR group and 870 patients were divided into non-ISR group,492 patients were divided into premature coronary heart disease group(50 ISR and 442 non-ISR)and 480 mature coronary heart disease group(52 ISR and 428 non-ISR).The differences of clinical characteristics and risk factors cause ISR between premature and mature coronary heart disease were analyzed.Results The hypertension,diabetes,family history,hemoglobin A1c(HbA1c)level,low density lipoprotein cholesterol(LDL-C)level,multiple branch lesions,number of stents and total stent length were higher in ISR group than those in the non-ISR group,and high density lipoprotein cholesterol(HDL-C)level was lower in ISR group than those in non-ISR group(P<0.05).Smoking,coronary heart disease family history,LDL-C level,multiple lesions,stents number and total stent length were higher in premature CHD ISR group than those in non-ISR group,while HDL-C level was lower than that in non-ISR(P<0.05).Hypertension,diabetes,HbA1c level,multiple lesions,stents number and total stent length were higher in mature CHD ISR group than those in non-ISR group,while stent diameter was smaller than that in non-ISR group(P<0.05).Multivariate logistic regression analysis showed that family history of coronary heart disease,HbA1c level,LDL-C level and total stent length were independent risk factors for ISR in total patients,and family history of coronary heart disease,LDL-C level and total stent length were independent risk factors for ISR in premature coronary heart disease group,while hypertension,diabetes,HbA1c level,total stent length and stent diameter were independent risk factors for ISR in ma

关 键 词：早发冠心病 经皮冠状动脉介入治疗 支架内再狭窄 危险因素 

分 类 号：R541[医药卫生—心血管疾病]