老年冠心病合并T2DM患者PCI术后支架内再狭窄的影响因素分析

Analysis of Influencing Factors of Stent Restenosis in Elderly Patients with Coronary Heart Disease Combined with T2DM

目的分析老年冠心病合并2型糖尿病(T2DM)患者经皮冠状动脉介入治疗(PCI)术后支架内再狭窄的影响因素。方法回顾性分析我院2018年10月-2019年10月期间行PCI手术的冠心病合并T2DM老年患者60例临床资料,将PCI术后支架内未狭窄的36例患者临床资料归为未狭窄组,将PCI术后支架内再狭窄的24例患者临床资料归为再狭窄组,分析老年冠心病合并T2DM患者PCI术后支架内再狭窄的影响因素。结果经单因素分析,再狭窄组中吸烟、支架直径≤3.0 mm的例数占比高于未狭窄组,空腹血糖、纤维蛋白原水平高于未狭窄组,差异有统计学意义(P<0.05);经多项Logistic回归分析,吸烟、支架直径≤3.0 mm、空腹血糖、纤维蛋白原水平高是老年冠心病合并T2DM患者PCI术后支架内再狭窄的危险因素(OR>1,P<0.05)。结论老年冠心病合并T2DM患者PCI术后支架内再狭窄发生与吸烟、支架直径、空腹血糖及纤维蛋白原水平有关,故临床上针对空腹血糖、纤维蛋白原水平较高、有吸烟史、PCI术中应用支架直径≤3.0 mm的患者时,应提高重视度并采取有效的措施。

Objective This paper aims to analyze the influencing factors of in-stent restenosis after percutaneous coronary intervention(PCI)in elderly patients with coronary heart disease and type 2 diabetes(T2 DM).Methods Retrospective analysis of 60 clinical data of elderly patients with coronary heart disease combined with T2 DM who underwent PCI during October 2018-October 2019 in our hospital.The clinical data of 36 patients with non-stenosis in the stent after PCI were classified as non-stenotic group.The clinical data of 24 patients with in-stent restenosis after PCI were classified as restenosis group,and the influencing factors of in-stent restenosis after PCI in elderly patients with coronary heart disease and T2 DM were analyzed.Results After univariate analysis,the proportion of smoking and stent diameter≤3.0 mm in the restenosis group was higher than that in the non-stenosed group,and the fasting blood glucose and fibrinogen levels were higher than those in the non-stenosed group.;After multiple logistic regression analysis,smoking,stent diameter≤3.0 mm,fasting blood glucose,and high fibrinogen levels were risk factors for restenosis in the stent after PCI in elderly patients with coronary heart disease and T2 DM(OR>1,P<0.05).Conclusion The occurrence of stent restenosis after PCI in elderly patients with coronary heart disease combined with T2 DM is related to smoking,stent diameter,fasting blood glucose and fibrinogen levels.Therefore,clinically,fasting blood glucose,high fibrinogen levels,smoking history,and PCI When using a patient with a stent diameter≤3.0 mm,attention should be increased and effective measures should be taken.