冠状动脉介入治疗后快速进展性冠状动脉狭窄的探讨

Coronary stenosis rapidly progressed after PCI

目的 探讨冠状动脉 (冠脉 )介入治疗 (PCI)后快速进展性冠脉狭窄的发生及其特点。方法 回顾分析 12个月内接受冠脉造影随访的PCI患者 10 3例 ,对比两次造影的狭窄部位、PCI干预情况及临床和危险因素。结果 10 3例接受造影随访的患者中 4 1 7%发生再狭窄 ,11 7%的患者为新发生的病变 ,而新发病变者中 4 1 7%发生于原PCI干预的血管 ,5 8 3%发生于未曾干预的血管。危险因素分析发现 ,新发病变患者糖尿病及高甘油三脂血症的发生率显著高于再狭窄患者。结论 PCI治疗后早期出现的症状除干预部位再狭窄外 ,尚有相当一部分患者发生新的快速进展性冠脉病变 ,这些患者糖尿病和高甘油三脂血症发生率高 。

Objective To discuss the occurrence and characteristics of the rapid progress of restenosis after percutaneous coronary intervention (PCI) Methods One hundred and three patients received coronary angiography twice within twelve months We retrospectively compared the places of stenosis in two angiograms, interventions of PCI, clinical procedures and other risk factors Results Restenosis was found in 41 7% of the patients New lesions happened in 11 7% of the patients, of whom 41 7% had new lesions in the interventioned vessel, and 58 3% had in the uninterventioned vessel Analysis of risk factors showed that incidences of diabetes and hypertriglyceridemia were significantly higher in the patients with new lesions than in those with restenosis Conclusion Symptoms that happened a short time after PCI are not only due to the restenosis of the intervention place, but also owe a lot to rapid progression of new coronary lesions The incidences of diabetes and hypertriglyceridemia are high in patients with rapid origression of new coronary lesions Its mechanism needs to be further proved