冠状动脉支架术后病人发生再狭窄的危险因素分析

Analysis of risk factors of post-stenting coronary restenosis

目的 探讨冠状动脉支架术后再狭窄的危险因素。方法 回顾性分析我院行冠状动脉内支架植入术并进行冠状动脉造影复查随访的 49例病人的临床和造影资料。用单因素和Logistic多因素逐步回归分析方法分析了病人临床特征及冠状动脉造影特征等 2 9个变量与再狭窄的关系。结果 复查冠状动脉造影时间 ,再狭窄组明显短于无再狭窄组。再狭窄组病人合并有糖尿病史比例较无狭窄组明显增多。Logistic回归分析 :再狭窄与复查造影时间、术前心肌梗死溶栓试验 (TIMI)血流、支架直径、支架植入后病变处管腔血流速度呈显著负相关 ;与糖尿病史、美国心脏病学会和美国心脏病协会 (ACC AHA)冠状动脉病变分类呈显著正相关。结论 冠状动脉支架术后病人发生再狭窄多在术后 6个月以内。糖尿病史 ,术前TIMI血流分级 ,支架直径 ,ACC AHA病变分型 ,支架植入后病变处管腔血流速度为支架植入术后再狭窄的独立危险因素。

Objective To assess the risk factors of restenosis after coronary stenting.Methods The data of 49 patients who had successfully underwent coronary stent implantation and angiographic reexamination were analyzed retrospectively.Univariate analysis and logistic regression analysis were used to study the relationship between restenosis and 29 factors including clinical characteristics and coronary angiographic characteristics.Results The time to angiographic reexamination in the restenosis group was significantly shorter than that in the non restenosis group.The rate of diabetes mellitus history in restenosis group was higher than that in non restenosis group.Logistic regression analysis revealed that there were negative correlations between the time to angiographic reexamination,TIMI blood stream grade of pathological blood vessels before the operation,stent diameter,blood flow rate of pathological blood vessel after coronary stenting and restenosis;and positive correlations between diabetes mellitus history,pathological change types of the coronary artery according to ACC/AHA classification and restenosis.Conclusions The restenosis often occurred within six months after coronary stenting.Diabetes mellitus history,TIMI blood stream grade of pathological blood vessel before the operation,stent diameter,ACC/AHA pathological type,blood flow rate of pathological blood vessel after coronary stenting are the independent risk factors of coronary post stenting restenosis.