药物涂层球囊治疗冠状动脉原位病变后靶血管正性重构的多因素分析  

Multifactor analysis of positive remodeling of target vessels in orthotopic coronary artery lesions after drug coated balloon therapy

作　　者：张帆[1] 贾永平[1] ZHANG Fan;JIA Yong-ping(Department of Cardiology,First Hospital of Shanxi Medical University,Taiyuan,Shanxi,030001,China)

机构地区：[1]山西医科大学第一医院心血管内科,山西太原030001

出　　处：《心血管康复医学杂志》2024年第3期322-326,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探究影响药物涂层球囊(DCB)治疗冠状动脉原位病变后靶血管正性重构的因素。方法:回顾性分析2019年6月-2021年6月于我院行DCB治疗冠状动脉原位病变并出院后行血管内超声(IVUS)或光学相干断层成像(OCT)复查冠状动脉靶血管情况的130例患者的临床资料。根据冠状动脉靶血管情况,患者被分为正性重构组(57例)和负性重构组(73例),采用多因素Logistic回归分析影响冠状动脉原位病变患者DCB治疗后靶血管正性重构的因素。结果:与负性重构组比较,正性重构组男性(74.0%比89.5%)、使用棘突球囊(31.5%比49.1%)、右冠或后降支左室后支病变(11.0%比28.1%)、年收入>10万元(19.2%比35.1%)、运动频数≥5次/周(6.8%比64.9%)比例、随访期间最小管腔直径[(2.22±0.87)mm比(2.95±0.34)mm]、住院费用[70218.42(51461.18,96114.17)元比91003.74(61930.16,116948.25)元]显著升高,吸烟史(67.1%比38.6%)和睡眠质量差(86.3%比22.8%)比例显著降低,P<0.05或<0.01。多因素Logistic回归分析显示运动频次≥3次/周、睡眠质量好和棘突/切割球囊的使用是此类患者DCB治疗后靶血管正性重构的独立保护因素(OR=0.014~0.097,P均<0.01),而吸烟史是其独立危险因素(OR=3.970,P=0.047)。结论:吸烟史是药物涂层球囊治疗冠状动脉原位病变后靶血管正性重构的独立危险因素,而运动频次≥3次/周、睡眠质量好和棘突/切割球囊的使用是其独立保护因素。Objective:To explore the factors affecting the positive remodeling of target vessels in orthotopic coronary artery lesions after drug coated balloon(DCB)treatment.Methods:A retrospective analysis was performed on clinical data of 130 patients who received DCB treatment for orthotopic coronary artery lesions in our hospital from June 2019 to June 2021 and underwent intravascular ultrasound(IVUS)or optical coherence tomography(OCT)to review the coronary target vessels after discharge.According to coronary target vessel condition,the patients were divided into positive remodeling group(n=57)and negative remodeling group(n=73).Multivariate Logistic regression was used to analyze the factors affecting positive remodeling of target vessels in patients with orthotopic coronary artery lesions after DCB treatment.Results:Compared with negative remodeling group,there were significant rise in percentages of male(74.0%vs.89.5%),usage of scoring balloon(31.5%vs.49.1%),right coronary or posterior descending left ventricular posterior branch lesions(11.0%vs.28.1%),annual income>100000 RMB(19.2%vs.35.1%),exercise frequency≥5 times/week(6.8%vs.64.9%),minimum lumen diameter during follow-up[(2.22±0.87)mm vs.(2.95±0.34)mm]and in-hospital fee[70218.42(51461.18,96114.17)RMB vs.91003.74(61930.16,116948.25)RMB],and significant reductions in percentages of smoking history(67.1%vs.38.6%)and poor sleep quality(86.3%vs.22.8%)in positive remodeling group,P<0.05 or<0.01.Multivariate Logistic regression analysis indicated that exercise frequency≥3 times/week,good sleep quality and usage of scoring/cutting balloon were independent protective factors for positive remodeling of target vessels after DCB treatment in these patients(OR=0.014~0.097,P<0.01 all),while smoking history was its independent risk factor(OR=3.970,P=0.047).Conclusion:Smoking history is an independent risk factor for positive remodeling of target vessels in orthotopic coronary artery lesions after DCB treatment,while exercise frequency≥3 times/week,good sleep quality

关 键 词：冠状动脉疾病 药物涂层球囊 靶血管重构 影响因素 

分 类 号：R541.4[医药卫生—心血管疾病]