冠心病患者经皮冠状动脉介入术后支架内再狭窄的影响因素分析

Analysis of Influencing Factors of In-stent Restenosis after Percutaneous Coronary Intervention in Patients with Coronary Heart Disease

目的:分析冠心病(CHD)患者经皮冠状动脉介入(PCI)术后支架内再狭窄(ISR)的影响因素。方法:回顾性分析2021年1月至2022年12月东莞南城医院收治的386例CHD患者资料,所有患者均由同一手术组进行PCI治疗。术后1年,根据复查结果将患者分为ISR组与对照组,比较两组患者相关资料,包括性别、年龄、病变部位、CHD家族史、吸烟史、合并高血压、血尿酸(SUA)水平、超敏C反应蛋白(hs-CRP)水平、动脉病变支数、合并糖尿病、支架直径,分析PCI后发生ISR的危险因素。结果:所有患者均随访1年后,发现有60例发生ISR,发生率为15.54%。ISR组吸烟史、合并高血压、SUA水平≥380 mmol·L^(-1)、hs-CRP水平≥8 mg·L^(-1)、合并糖尿病、支架直径<3 mm的占比均高于对照组,差异均具有统计学意义(P<0.05);两组患者性别、年龄、病变部位、CHD家族史、动脉病变支数等指标比较,差异均无统计学意义(P>0.05)。多因素logistic回归分析显示:吸烟史、合并高血压、SUA水平≥380 mmol·L^(-1)、hs-CRP水平≥8 mg·L^(-1)、合并糖尿病、支架直径<3 mm是患者PCI术后发生ISR的独立危险因素(P<0.05)。结论:受吸烟史、合并高血压、SUA水平≥380 mmol·L^(-1)、hs-CRP水平≥8 mg·L^(-1)、合并糖尿病、支架直径<3 mm等因素影响,患者PCI术后ISR的发生率较高,临床可针对上述指标积极制定预防措施,降低ISR发生率。

Objective To analyze the influencing factors of in-stent restenosis(ISR)in patients with coronary heart disease(CHD)after percutaneous coronary intervention(PCI).Methods A retrospective analysis was conducted on data from 386 patients with CHD admitted to Dongguan Nancheng Hospital from January 2021 to December 2022.All patients underwent PCI treatment by the same surgical team.One year post-procedure,patients were categorized into ISR and control groups based on reexamination results.Relevant patient data,including gender,age,lesion location,family history of CHD,smoking history,hypertension,serum uric acid(SUA)level,high-sensitivity C-reactive protein(hs-CRP)level,number of diseased arteries,diabetes,and stent diameter were compared between the two groups to analyze the risk factors for ISR occurrence after PCI.Results All patients were followed up for one year,revealing 60 cases of ISR,with an incidence rate of 15.54%.The proportions of smoking history,hypertension,SUA level≥380 mmol·L^(-1),hs-CRP level≥8 mg·L^(-1),diabetes,and stent diameter<3 mm in the ISR group were higher than those in the control group,with statistically significant differences(P<0.05).There was no statistically significant differences in gender,age,lesion location,family history of CHD,and number of diseased arteries between the two groups(P>0.05).Multivariate logistic regression analysis indicated that smoking history,hypertension,SUA level≥380 mmol·L^(-1),hs-CRP level≥8 mg·L^(-1),diabetes,and stent diameter<3 mm were independent risk factors for ISR occurrence after PCI(P<0.05).Conclusion Patients with factors such as smoking history,hypertension,SUA level≥380 mmol·L^(-1),hs-CRP level≥8 mg·L^(-1),diabetes,and stent diameter<3 mm have a higher incidence of ISR after PCI.Clinically,proactive preventive measures can be taken targeting these indicators to reduce the occurrence of ISR.