新疆维吾尔族和哈萨克族冠心病患者经皮冠状动脉介入治疗术支架内亚急性血栓形成因素分析

Causes of subacute coronary stent thrombosis among different races in XinJiang province: a report of 21 cases

目的探讨支架内亚急性血栓形成民族差异的原因和防治策略。方法回顾性地对术后发生支架内亚急性血栓(subacutestentthrombosis,SST)形成的21例不同民族(汉族、维吾尔族、哈萨克族)患者的血液流变学、凝血机制、血管病变特点、手术操作过程和治疗措施等资料进行分析,采用单因素和Logistic多因素逐步回归分析。结果维吾尔族和哈萨克族经皮冠状动脉介入治疗(percuta-neouscoronaryinterventions,PCI)患者中SST发生率明显高于汉族患者(1.4%比0.47%;5.4%比0.47%,P均<0.05)。维吾尔族和哈萨克族SST患者术前血浆纤维蛋白原、全血黏度低切及血浆比黏度较汉族明显增高(P均<0.05);多因素分析民族,血浆纤维蛋白原水平是SST的独立危险因素,比数比(OR)分别为1.043和1.018。结论PCI术后SST发生率可能存在民族差异,其原因可能与种族间凝血机制差异导致的高凝状态有关,在常规治疗的基础上,适当应用降低血浆纤维蛋白原含量的药物,可能助于预防SST的形成。

Objective To explore the causes and possible treatment for subacute coronary stent thrombosis （SST） after percutaneous coronary interventions （PCI） in the races of Han, Uygur and Kazak in Xin Jiang Province. Methods The variables of hemodynamic, blood coagulation, lesions characteristics, the course of operation and relative treatment of 21 cases of different races （Han. Uygur and Kazak） were reviewed and underwent logistic regression analysis. Results The incidence of SST were higher in the Uygur and the Kazak people than that in the Han group after PCI （ 1.4% vs 0.47% ; 5.4% vs 0.47%, P 〈 0.05）. The blood viscosity and the plasm fibrinogen levels were also higher in the Uygur and the Kazak groups than that in the Hart group （ P 〈 0.05）. Logistic regression analysis revealed that racial difference （ OR = 1.043） and plasm fibrinogen levels before procedure （ OR = 1.018） were positively correlated with ssr. Conclusion The incidence of SST after PCI is different among different races and its possible mechanism may to due to the difference in blood riscosity or coagulation mechanism. Application of defibrination may be a possible prevention of SST.