支架长度与急性冠脉综合征支架植入术后支架内再狭窄的关系  

Relationship Between Stent Length and In-stent Restenosis in Patients with Acute Coronary Syndrome After Stent Implantation

作　　者：付秋玉[1] 刘家勉[1] 张小强[1] 郑庆昆[1] 黄晓波[1] Fu Qiuyu;Liu Jiamian;Zhang Xiaoqiang(Department of Cardiology,the Second People′s Hospital of Chengdu,Chengdu,Sichuan 610017,China)

机构地区：[1]成都市第二人民医院心内科,四川成都610017

出　　处：《四川医学》2024年第7期744-748,共5页Sichuan Medical Journal

摘　　要：目的探讨支架长度与急性冠脉综合征(ACS)经皮冠状动脉支架植入术后支架内再狭窄(ISR)的关系。方法回顾性分析2020年1月至2021年12月我院ACS成功接受支架植入的患者206例,术后12个月随访行冠脉造影复查,根据造影情况分为ISR组和非ISR组。采用Logistic回归模型和ROC曲线下面积来确定支架长度在预测ISR中的作用。结果ACS行急诊经皮冠状动脉介入治疗(PCI)并支架植入术后12个月发生ISR患者62例(30.1%),非ISR患者144例(69.9%)。ISR组前降支、回旋支、右冠脉血管病变狭窄程度高于非ISR组,支架长度大于非ISR组,差异有统计学意义(P<0.05)。多因素Logistics回归分析显示,支架长度和前降支、回旋支病变狭窄程度与ISR的风险相关。支架长度预测ISR的AUC为0.701(95%CI 0.594~0.803),支架长度、前降支病变狭窄程度和回旋支病变狭窄程度联合预测ISR的AUC为0.860(95%CI 0.763~0.957)。支架长度预测ISR风险的敏感度为0.742,特异度为0.528,最佳临界值为29 mm。结论支架长度与ISR相关,其对ACS支架植入术后ISR的发生风险有一定的预测价值。Objective To investigate relationship between stent length and in-stent restenosis(ISR)after percutaneous coronary artery stent implantation in acute coronary syndrome(ACS).Methods A retrospective analysis was performed for 206 patients who received stent implantation in ACS in our hospital from January 2020 to December 2021,and coronary angiography was followed up 12 months after stent implantation,and they were divided into ISR group and non-ISR group according to the contrast situation.Logistic regression models and area under the ROC curve were used to determine the role of stent length in predicting ISR.Results 62 patients(30.1%)had ISR and 144 cases(69.9%)had non-ISR 12 months after emergency PCI and stent implantation with ACS.The stenosis of anterior descending artery,circumflex artery and right coronary artery lesions in the ISR group was higher than that in the non-ISR group,and the stent length was significantly higher than that in the non-ISR group(P<0.05).Multivariate Logistics regression analysis showed that stent length and stenosis of anterior descending artery and circumflex lesions were associated with the risk of ISR.The AUC of stent length predicted ISR was 0.701(95%CI 0.594~0.803),and the AUC of stent length,anterior descending artery stenosis,and circumflex artery stenosis was 0.860(95%CI 0.763~0.957).The sensitivity and specificity of stent length in predicting ISR risk were 0.742,the specificity was 0.528,and the optimal cut-off value was 29 mm.Conclusion Stent length would be correlated with ISR and would have a certain predictive value for the risk of ISR after ACS stent implantation.

关 键 词：经皮冠状动脉介入治疗 急性冠脉综合征 支架内再狭窄 支架长度 

分 类 号：R541.4[医药卫生—心血管疾病]