摘要
目的探讨冠状动脉药物洗脱支架内再狭窄的危险因素。方法对157例行冠状动脉药物洗脱支架植入术患者的临床资料进行回顾性分析，按照冠状动脉造影结果分为再狭窄组33例和无再狭窄组124例，采用单因素及Logistic多因素回归分析其临床及冠状动脉造影特征与药物洗脱支架内再狭窄的相关性。结果再狭窄组33例，糖尿病18例（54．5％），术后反复心绞痛26例（78．8％）；无再狭窄组124例，糖尿病31例（25．0％），术后反复心绞痛72例（58．1％），组间差异有统计学意义（X^2=10．60，P〈0．01；）（2=4．77，P=0．03）。2组慢性完全闭塞分别为11例（19．3％）、12例（7．6％），分叉病变12例（21．1％）、16例（10．2％），弥漫病变15例（26．3％）、19例（12．1％），组间差异有统计学意义（x。值分别为5．92、4．34、6．32，P均〈0．05）。再狭窄组植入支架57枚，无再狭窄组植入157枚。logistic多因素分析显示糖尿病、术后反复心绞痛、慢性完全闭塞、分叉病变、弥漫病变和支架长度与支架内再狭窄相关（OR分别为3．52、2．59、3．05、3．14、3．08、0．93，95％C1分别为1．56～7．90，1．02～6．59，1．11～8．36，1．30～7．59。1．34～7．05，0．88—0．98，P均〈0．05）。结论冠状动脉药物洗脱支架植入术后，糖尿病史、术后反复发生心绞痛、慢性完全闭塞、分叉病变、弥漫病变及支架长度为支架内再狭窄的危险因素。
Objective To investigate the risk factors of in-stent restenosis （ISR） after coronary implantation of drug-eluting stent. Methods One hundred and fifty-seven patients including 118 males and 39 females,who underwent successful implantation of drug-eluting stem, were recruited in the study. The patients were divided into the restenosis group （33 patients） and non-restenosis group （124 patients） according to the angiographic results. The associations of ISR with clinical and coronary angiographic characteristics were analyzed using univiriate analysis and logistic regression. Results In the restenosis group,there were 18 cases of diabetes mellitus （54. 5% ）,26 cases of frequency angina （78. 8% ）,which were significantly higher than those of 31 cases of diabetes （25.0%） and 72 case of frequent angina （58. 1% ） in the non-restenosis group （ X^2 = 10. 60, P 〈 0. 01, X^2 = 4. 77, P = 0.03 for diabetes mellitus and frequent angina, respectively）. Compared to non-restenosis group, the occurrence rates of chronic total occasion, bifurcatus lesions, diffuse lesions were significantly higher in the restenosis group （ 19. 3% vs 7. 6% X2 =5.92,21.1% vs 10. 2% X^2 =4. 34,26. 3% vs 12. 1% X^2 =6. 32,Ps 〈0. 05）. Fifty-seven stents were implanted into the restenosis group,and one hundred and fifty-seven into the non-restenosis group. Logistic regression analysis showed that diabetes, frequent angina, chronic total occlusion lesions, bifurcatus lesions, diffuse lesions, stent length and diameter were significantly associated with restenosis （ OR value were 3.52,2. 59,3.05,3.14,3.08,0. 93,95% CI were 1.56 - 7.90, 1.02 - 6. 59,1.11 - 8. 36,1.30 - 7.59,1.34 - 7.05,0. 88 - 0. 98 respectively, Ps 〈 0. 05 ）. Conclusion After implantation of drug-eluting stent, diabetes mellitus, chronic total occasion lesions, frequent angina, diffuse lesions,bifurcatus lesions and stent length and diameter are associated with follow-up restenosis.
出处
《中国综合临床》
2011年第2期136-139,共4页
Clinical Medicine of China
