冠心病支架植入术后胸痛原因及再狭窄相关因素分析

Reasons of Chest Pain After Coronary Artery Stent Implantation and Evaluation of Risk Factors on Coronary Instent Restenosis

目的:观察116例冠心病支架植入术后再发胸痛的患者,分析其胸痛及导致支架内再狭窄发生的原因。方法:对116例支架植入术后再发胸痛的患者进行冠脉造影、心电图、心脏B超等检查,了解胸痛的原因。根据有无再狭窄将患者分为再狭窄组和非再狭窄组,将两组患者的临床和支架相关因素进行对比分析。结果:116例患者中,48例出现新的部位狭窄(或原有的狭窄程度加重),28例出现支架内再狭窄,16例伴心律失常,7例为胃炎,6例为胆囊结石症,4例为食道返流症,其它原因11例。性别、吸烟、支架数目、高血压、总胆固醇(TC)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)等因素对是否形成支架内再狭窄无显著性意义(P>0.05),患者年龄、植入时间、糖尿病、甘油三酯(TG)、支架的长度、直径对支架内再狭窄发生有显著性影响(P<0.05)。结论:出现新的部位病变和支架内再狭窄是支架植入术后再发胸痛的最常见原因;年龄、植入时间、糖尿病、甘油三酯、支架的长度、直径可能是与支架内再狭窄发生的危险因素。

Objective： To investigate reasons of chest pain in 116 patients after coronary artery stent implantation and to evaluate relating factors on coronary instent restenosis. Methods： All patients underwent coronary angiography, ECG and echocadiography. According to the results of coronary angiography, they were divided into restenosis group and non-restenosis group. The clinical and stent relating factors affecting instent restenosis were compared between the two groups. Results： Among the 116 patients, 48 patients had stenosis on new position, 28 patients had instent restenosis, 16 patients had arrhythmia, seven patients had gastritis, six patients had gall-stone, four patients had GERD, and 11 patient had other diseases. Gender, numbers of stents, smoking, hypertension, TC, LDL and HDL had no significant effect on restenosis（P〉0.05）. Age, implanted time, diabetes mellitus, TG and the length and diameter of stents had significant effect on restenosis （P〈0.05）. Conclusion： New coronary stenotic lesion and in-stent restenosis are the major reasons of chest pain in patients after coronary artery stent implantation. Age, implanted time, diabetes mellitus, TG and length and diameter of stents may be risk factors on coronary instent restenosis.