经皮腔内冠状动脉成形术后再狭窄的临床多因素分析

Multivariate analysis of clinical factors in restenosis after percutaneous transluminal coronary agioplasty

目的:通过对再狭窄和临床易患因素关系的分析,希望找出再狭窄的独立预测因素.方法;本研究回顾性分析了50例(共61支血管)在我院成功进行了PTCA术,并于术后6个月有完整冠状动脉造影随访资料的病人,通过单因素及多因素方法分析再狭窄与临床因素的关系.结果:再狭窄率为49.2%(30/61).单因素分析中发现病变AHA/ACC分型B和C型、长病变、术前直径狭窄百分比较大、术前最小管腔直径较小组的再狭窄率高,以上4个因素和再狭窄的关系有显著统计学意义(P<0.01).球囊最大充气压较大和梗塞相关血管的再狭窄率较高,以上2因素和再狭窄的关系有统计学意义(P<0.05).多元Logistic回归分析结果显示病变分型为B和C型、梗塞相关血管、最大球囊充气压较大可使再狭窄率增高.结论:病变分型、梗塞相关血管、球囊最大充气压力再狭窄的独立预测因素.

Objective: To found the independent predictors for restenosis after percutaneous transluminal coronary angioplasty (PTCA), Methods: Quantitative angiography was performed on 50 patients(61 successfuly dilated lesions)at angioplasty and at 6 - month follow - up, and then univariate analysis and multivariate logistic regression analysis were performed to identify correlates of restenosis and clinical factors. Results: The total restenosis rate was 49.2% (30 of 61 lesions) and according to univariate analysis the patients who with the ACC/ AHA lesion type B and C, high percentage diameter stenosis before PTCA. The less minimal lumen diameter before PTCA, long lesion, had a higher rate of restenosis(P< 0.01) .High maximal inflation pressure and infarct - related lesion are associated with high rate of restenosis(P < 0.05) . Multivariate logistic regression analysis showed that lesion type B and C, infarct - related lesion, high maximal inflation pressure had high rate of restenosis. Conclusion: Lesion type, infarct - related lesion and maximal inflation pressure were independent predictors for restenosis.