冠状动脉支架植入术后进行强化药物治疗后发生支架内再狭窄的影响因素分析  

Analysis of the influencing factors of in-stent restenosis after intensified drug therapy following coronary stent implantation

作　　者：李晓飞 杨柳 崔慢飞 张云飞 李晓琪 Li Xiaofei;Yang Liu;Cui Manfei;Zhang Yunfei;Li Xiaoqi(Cardiac Rehabilitation Center,Beijing Rehabilitation Hospital,Capital Medical University,Beijing 100144,China;CCU,Beijing Rehabilitation Hospital,Capital Medical University,Beijing 100144,China)

机构地区：[1]首都医科大学附属北京康复医院心脏康复中心,北京100144 [2]首都医科大学附属北京康复医院CCU,北京100144

出　　处：《血管与腔内血管外科杂志》2025年第1期35-39,共5页Journal of Vascular and Endovascular Surgery

基　　金：首都医科大学附属北京康复医院科研发展专项项目(2023-16)。

摘　　要：目的 探讨冠状动脉支架植入术后进行强化药物治疗后发生支架内再狭窄(ISR)的影响因素。方法 收集2022年6月至2023年5月于首都医科大学附属北京康复医院接受药物洗脱支架(DES)植入的176例冠心病患者的临床资料,按照1年随访期间是否发生ISR将其分为ISR组(n=27)与对照组(n=149)。收集所有患者支架植入术前的临床特征、冠状动脉介入术的主要指标、术后1年随访期间的干预措施、1年随访期末冠状动脉造影复查结果及随访期间的主要心血管不良事件(MACE)发生情况,分析DES植入术后进行强化药物治疗后发生ISR的影响因素。结果 两组患者老年(年龄≥60岁)、吸烟、糖尿病、多支病变、C反应蛋白(CRP)升高、发生至少1次心绞痛、因心肌缺血再次住院行再血管化治疗比例比较,差异均有统计学意义(P<0.05)。多因素分析结果显示,老年(年龄≥60岁)、吸烟、糖尿病、多支病变、随访期间CRP升高均是DES植入术后进行强化药物治疗后发生ISR的独立危险因素(P<0.05)。结论 DES植入术后进行强化药物治疗仍有部分冠心病患者发生ISR,老年(年龄≥60岁)、吸烟、糖尿病、多支病变和随访期间CRP升高均是其独立危险因素,临床实践中可以适当参考以识别高危患者。Objective To investigate the influencing factors of in-trastent restenosis(ISR)after intensive drug therapy following coronary stent implantation.Method Clinical data of 176 patients with coronary heart disease who received drug-eluting stent(DES)implantation in Beijing Rehabilitation Hospital,Capital Medical University from June 2022 to May 2023 were collected.According to whether ISR occurred during 1-year follow-up,they were divided into ISR group(n=27)and control group(n=149).Clinical features before stenting,main indicators of coronary intervention,intervention measures during 1-year postoperative follow-up,coronary angiography review results at the end of 1-year follow-up and major cardiovascular adverse events(MACE)during follow-up were collected for all patients,and the influencing factors of ISR after intensive drug therapy following DES implantation were analyzed.Result There were significant differences between the two groups in the proportion of elderly patients(age≥60 years old),smoking,diabetes,multi vessel disease,C-reactive protein(CRP)increase,angina pectoris at least once,and revascularization treatment for re-hospitalization due to myocardial ischemia(P<0.05).Multivariate analysis showed that old age(≥60 years old),smoking,diabetes,multi vessel lesions,and CRP elevation during follow-up were independent risk factors for ISR after intensive drug treatment following DES implantation(P<0.05).Conclusion Some patients with coronary heart disease still have ISR after intensive drug therapy following coronary stent implantation.Old age(≥60 years old),smoking,diabetes,multi vessel disease and CRP increase during follow-up are independent risk factors.It can be properly referred to in clinical practice to identify high-risk patients.

关 键 词：强化药物治疗 冠状动脉支架植入术 药物洗脱支架 支架内再狭窄 影响因素 

分 类 号：R543[医药卫生—心血管疾病]