冠状动脉分叉病变药物涂层球囊成形术后再狭窄的相关危险因素分析  

Analysis of related risk factors for restenosis of coronary bifurcation lesions after drug coated balloon angioplasty

作　　者：郑胜昌 刑军辉 刘恒道 辜和平 陶海龙[1] ZHENG Sheng-chang;XING Jun-hui;LIU Heng-dao;GU He-ping;TAO Hai-long(Depaetment of Cardiology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;Puyang Oilfield General Hospital,Puyang,Henan 457001,China)

机构地区：[1]郑州大学第一附属医院心内科,郑州450000 [2]濮阳市油田总医院,河南濮阳457001

出　　处：《医药论坛杂志》2023年第5期1-4,8,共5页Journal of Medical Forum

基　　金：河南省自然科学基金青年项目(202300410396)。

摘　　要：目的研究冠状动脉分叉病变边支药物涂层球囊(drug coated balloon,DCB)成形术后再狭窄的相关危险因素。方法回顾性分析2020年1月至2022年1月于郑州大学第一附属医院心内科行冠状动脉分叉病变DCB介入治疗患者,采用主支血管药物洗脱支架(drug eluting stent,DES)置入或DCB成形术,边支血管行DCB成形术。共148例患者完成术后冠脉造影复查,按照边支造影复查结果,将患者分为再狭窄组(55例)和无狭窄组(93例)。比较两组间临床资料和冠脉病变特征的差异,心血管不良事件(定义为非致命性心肌梗死、靶病变再次血运重建、CABG和支架血栓复合终点)发生率,logistic回归分析冠脉再狭窄的危险因素。结果再狭窄组患者吸烟史、饮酒史、低密度脂蛋白胆固醇(LDL)高于无狭窄组(70.91%vs.89.09%,P=0.040;53.76%vs.73.12%,P=0.021;1.73±0.61vs.1.51±0.57,P=0.033),再狭窄组的心血管不良事件发生率高于无狭窄组(70.90%vs.52.70%,P=0.029)。logistic回归分析显示,LDL[(1.089,3.960),P=0.026]、靶病变位置前降支(LAD)[(1.133,17.656),P=0.033]、回旋支(LCX)[(1.481,21.258),P=0.011]是再狭窄的独立危险因素。结论LDL和靶病变位置(LAD、LCX)是冠状动脉分叉病变药物涂层球囊成形术后再狭窄的独立危险因素。Objective To investigate the risk factors of restenosis after drug coated balloon(DCB)angioplasty for side branches of coronary bifurcation lesions.Methods Retrospective analysis was made on the patients with coronary bifurcation disease undergoing DCB interventional therapy in the Department of Cardiology of the First Affiliated Hospital of Zhengzhou University from January 2020 to January 2022,who were treated with drug eluting stent(DES)implantation or DCB angioplasty in the main branch,and DCB angioplasty in the side branch.Totally 148 patients completed postoperative coronary angiography reexamination and were divided into restenosis group(55 cases)and no stenosis group(93 cases)according to the results of coronary angiography.To compare the differences in clinical data and characteristics of coronary artery disease between the two groups,the incidence of cardiovascular adverse events(defined as non fatal myocardial infarction,target lesion revascularization,CABG and stent thrombosis composite endpoint),and the risk factors of coronary restenosis by logistic regression analysis.Results The history of smoking,drinking and low density lipoprotein cholesterol(LDL)in restenosis group were higher than those of non stenosis group(70.91%vs.89.09%,P=0.040;53.76%vs.73.12%,P=0.021;1.73±0.61vs.1.51±0.57,P=0.033).The incidence of adverse cardiovascular events in restenosis group was higher than that of nonstenosis group(70.90%vs.52.70%,P=0.029).Logistic regression analysis showed that LDL[(1.089,3.960),P=0.026],target lesion location LAD[(1.133,17.656),P=0.033],target lesion location LCX[(1.481,21.258),P=0.011]were independent risk factors for restenosis.Conclusion LDL and target lesion location(LAD,LCX)are independent risk factors for restenosis of coronary bifurcation lesions after drug coated balloon angioplasty.

关 键 词：冠状动脉分叉病变 药物涂层球囊 再狭窄 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]