老年冠心病冠脉支架再狭窄相关因素调查

Investigation of the relative factors of coronary instent restenosis in elderly coronary heart disease patients

目的研究老年人冠脉病变的特点及支架植入后再狭窄的发生情况及相关因素。方法随机选择冠脉造影资料较全的老年冠心病患者150例,分析冠脉病变特点,并对其中复查冠脉造影的96例患者再狭窄情况,及再狭窄相关因素(年龄、性别、高血压、糖尿病、高血脂及冠脉病变特点、支架性质)进行分析。结果老年人多支病变多见75.3%,再狭窄率26.3%,其中裸支架再狭窄率36.1%(13/36),紫杉醇23.3%(7/30),雷帕霉素16.7%(5/30)。狭窄及无狭窄组患者的年龄、血脂差异无统计学意义。两组糖尿病病例数、支架长度、支架数量差异具有统计学意义,裸支架组的再狭窄率明显高于药物洗脱支架组。结论糖尿病、支架长度、多个支架、支架性质均为再狭窄的相关因素。

Objective To study the leision characteristics of elderly coronary heart disease patients, the coronary instent restenosis institution after percutaneous coronary intervention（PCI）and the related factors. Methods 150 elderly coronary heart disease patients who have carried out PCI were randomly chose,among them 96 patients reexamined by percutaneous coronary angiography. Characterstics of coronary leisions, and the institution of restenosis and the related factors of restenosis（age, gender, hypertention, diabetes mellitus, serum lipid, the characterstics of coronary lesions and the nature of instent）were analysed. Results the multiple lesions were common in elderly coronary heart disease patients75.3% ;the rate of restenosis was 26.3% ;the restenosis rate of bare metal stent was 36.1%（13/36）;the restenosis rate of paclitaxel-eluting stent was 23.3%（7/30）;the restenosis rate of rapamycin-eluting stent was 16.7%（5/30）. There were no significantly difference in the age,serum lipid between the restenosis group and non-restenosis group. There were difference in the case of diabetes mellitus patients, the length of stent and the number of stent between the restenosis group and the non-restenosis group;the rate of restenosis was higher in bare metal stent group than in drugeluting stent group. Conclusions Diabetes mellitus,the length of stent,the number of stent and the nature of stent are the relative factors of instent restenosis.