冠状动脉支架植入术后ISR预测模型的构建及药物洗脱球囊联合切割球囊的疗效研究  

Construction of ISR prediction model after coronary stent implantation and the efficacy of drug-eluting balloon combined with cutting balloon

作　　者：伍灏堃 樊婷[2] 余天浩[1] 廖文君 李晓伟 WU Haokun;FAN Ting;YU Tianhao;LIAO Wenjun;LI Xiaowei(The First Department of Cardiology,Guangdong Second Provincial General Hospital,Guangzhou,Guangdong 510317,China;Hospital Infection Department,Guangdong Second Provincial General Hospital,Guangzhou,Guangdong 510317,China)

机构地区：[1]广东省第二人民医院心内一科,广东广州510317 [2]广东省第二人民医院院感科,广东广州510317

出　　处：《中国医学工程》2023年第9期24-29,共6页China Medical Engineering

基　　金：2021年度广东省医学科研项目(B2021227)。

摘　　要：目的研究冠状动脉支架植入术后支架内再狭窄(ISR)预测模型的构建及药物洗脱球囊联合切割球囊的疗效。方法本研究采取前瞻性研究,以冠状动脉支架置入手术后发生ISR(狭窄率≥50%)并于2021年7月至2021年12月期间在广东省第二人民医院治疗的72例患者作为研究对象,另选取同期未发生ISR冠状动脉支架置入手术患者72例作为影响因素分析,将ISR患者分为观察组与对照组,每组36例,观察组患者采取药物洗脱球囊联合切割球囊治疗,对照组患者给予药物洗脱球囊治疗。分析冠状动脉支架植入术后ISR发生的危险因素,分析观察组与对照组的治疗效果。结果ISR组与非ISR组患者的血压、吸烟、支架直径、支架长度、支架部位、支架数量、支架内管腔狭窄率、最小管腔直径、参考血管直径、空腹血糖、球囊扩张时间、糖化血红蛋白、胆固醇、低密度脂蛋白、高敏C反应蛋白、白细胞,术后使用阿司匹林、硝酸酯类、他汀类、β受体阻滞剂、血管紧张素转化酶抑制剂(ACEI)、血管紧张素Ⅱ受体(ARB)、钙通道阻滞剂药物之间的差异有统计学意义(P<0.05);通过多因素分析,支架部位为前降支、球囊扩张时间、较高的血压、吸烟、支架直径、支架长度、支架部位、支架数量、支架内管腔狭窄率、最小管腔直径、参考血管直径、空腹血糖、糖化血红蛋白、胆固醇、低密度脂蛋白、高敏C反应蛋白、白细胞,术后较低使用阿司匹林、硝酸酯类、他汀类、β受体阻滞剂、ACEI、ARB、钙通道阻滞剂药物均是造成患者发生ISR独立危险因素。经过治疗后,两组患者的血管内径以及狭窄率显著改善。结论支架部位为前降支、球囊扩张时间、较高的血压、吸烟、支架直径、支架长度、支架部位、支架数量、支架内管腔狭窄率、最小管腔直径、参考血管直径、空腹血糖、糖化血红蛋白、胆固醇、低【Objective】To study the prediction model of in-stent restenosis(ISR)after coronary stent implantation and the efficacy of drug eluting balloon combined with cutting balloon.【Methods】A prospective study was carried out in this study.Seventy-two patients who suffered from ISR(stenosis rate≥50%)after coronary stent implantation and were treated in our hospital from July 2021 to December 2021 were selected as the study objects.Seventy-two patients who did not suffer from ISR during the same period were selected as the analysis of influencing factors.ISR patients were divided into observation group and control group,with 36 patients in each group.Patients in the observation group were treated with drug eluting balloon combined with cutting balloon,while patients in the control group were treated with drug eluting balloon.The risk factors of ISR after coronary stent implantation,and the treatment effect of the observation group and the control group were analyzed.【Results】There were significant differences in blood pressure,smoking,stent diameter,stent length,stent location,stent number,stent lumen stenosis rate,minimum lumen diameter,reference vessel diameter,fasting blood glucose,balloon dilation time,glycosylated hemoglobin,cholesterol,low-density lipoprotein,high-sensitivity C-reactive protein,white blood cells,aspirin,nitrate,statins,βreceptor blockers,angiotensin converting enzyme inhibitor(ACEI),angiotensin II receptor blockers(ARB)and calcium channel blockers between ISR patients and non-ISR patients(P<0.05).By multifactor analysis,the stent site was anterior descending branch,balloon dilation time,higher blood pressure,smoking,stent diameter,stent length,stent site,number of stents,stent lumen stenosis rate,minimum lumen diameter,reference vessel diameter,fasting blood glucose,glycosylated hemoglobin,cholesterol,low-density lipoprotein,high-sensitivity C-reactive protein,white blood cells,low use of aspirin,nitrates,statins,βreceptor blockers,ACEI,ARB and calcium channel blockers are independen

关 键 词：冠状动脉支架植入术 危险因素 切割球囊 药物脱洗球囊 

分 类 号：R541.4[医药卫生—心血管疾病]