冠状动脉钙化病变植入支架术后与支架内再狭窄的相关性分析  

Correlation Between In-stent Restenosis and Coronary Calcification After Percutaneous Coronary Intervention

作　　者：王宇 高艳辉[1] 范莎莎 宋湘[1] 王利良 李光男[1] 李名扬 陆井伟 李萌[1] Wang Yu;Gao Yanhui;Fan Shasha(The Fourth Affiliated Hospital of Harbin Medical University,Harbin,Heilongjiang,150001,China)

机构地区：[1]哈尔滨医科大学附属第四医院,黑龙江哈尔滨150001

出　　处：《黑龙江医学》2024年第23期2832-2834,共3页Heilongjiang Medical Journal

摘　　要：目的:探讨钙化病变植入支架后与支架内再狭窄(ISR)的相关性,旨在为冠状动脉粥样硬化性心脏病(CHD)的治疗提供新的临床依据和指导策略。方法:选取2014年6月—2019年6月因CHD在哈尔滨医科大学附属第四医院行经皮冠状动脉介入治疗(PCI)的466例患者作为研究对象,根据造影结果将其分为ISR组(n=32)和非ISR组(n=434)。回顾性分析两组患者的一般临床资料、介入资料,同时判断支架部位有无明显钙化病变,采用单因素分析及二元logistic回归分析上述数据。结果:ISR组患者合并糖尿病高于非ISR组,差异有统计学意义(χ^(2)=0.444,P<0.05)。ISR组患者钙化病变率、支架重叠率、小管径支架率均高于非ISR组,差异均有统计学意义(χ^(2)=1.192、0.180、1.491,P<0.05)。二元logistic回归分析结果显示,钙化斑块、糖尿病、小管径支架均是冠状动脉钙化病变PCI术后发生ISR的独立危险因素。结论:冠状动脉钙化病变行PCI治疗是ISR的独立危险因素,尤其是合并糖尿病、靶病变血管管径较小需要植入小管径支架的患者。Objective:To identify the correlation between in-stent restenosis and coronary calcification after percutaneous coronary intervention,so as to provide clinical basis and guidance countermeasures for CHD treatment.Methods:Patients underwent PCI and coronary angiography reexamination completed in the Central Catheterization Room,The Fourth Affiliated Hospital of Harbin Medical University from June 2014 to June 2019 were collected,and coronary angiography reexaminations were performed.According to the reexamination results,the patients were divided into ISR group and non-ISR group.The general clinical data and interventional imaging data of the two groups of patients were retrospectively acquired,and the above data was analyzed by single-factor analysis and multivariate logistic regression analysis.Results:Compared with the non-ISR group,the percentage of calcification in the ISR group increased significantly(χ^(2)=0.444,P<0.05).The rate of calcification,stent overlap and small diameter stent in ISR group were higher than those in non-ISR group,with statistically significant difference(χ^(2)=1.192,0.180,1.491;P<0.05).Binary logistic regression analysis showed that calcified plaque,diabetes and small diameter stents were independent risk factors for ISR after PCI.Conclusion:PCI treatment for coronary artery calcification is an independent risk factor for ISR,especially in patients with diabetes mellitus and small vascular diameter of the target lesion requiring implantation of small-diameter stents.

关 键 词：冠状动脉钙化斑块 支架内再狭窄 冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]