左前降支支架置入术后支架近端冠状动脉重塑的临床研究

The clinical research of remodeling of stents proximal coronary blood vessels after percutaneous coronary inter vention

目的研究冠状动脉病变支架置人后血管的变化，进一步探讨支架置人对血管重塑的影响。方法因各种急性冠状动脉事件而行经皮冠状动脉介入治疗（PCI）术28例，应用血管内超声的方法，测量置入支架后支架近端（1em）处的血管容积，1年后复查冠状动脉造影，重复测量该部位的血管容积，应用SPSS软件分析包行，检验进行统计分析。结果28例患者中正性重塑23例，零重塑1例，负性重塑4例。正性重塑中最大达到89．0％，平均（23．0±5．7）％；负性重塑平均（12．0±1．1）％。而正性重塑组中发生心脏缺血事件3例，支架内狭窄13例，最大管腔面积狭窄达70％；而零重塑1例、负性重塑4例中无缺血事件发生。结论支架近端血管的正性重塑对支架再狭窄可能有相关陛，从而提醒我们要更加慎重的选择支架手术。

Objective To research the changes of blood vessels of coronary artery disease stent, and further discuss the influences of stenting vascular remodeling. Methods Twenty eight stents Percutaneous coronary inter vention（PCI） was implanted because of all sorts of acute coronary events. Using intravaseular ultrasound method, measure the stent placement stents proximal （ 1 cm） vascular volume. One year later, recheck with coronary angiography and repetitive measure the blood vessels volume, SPSS software analysis package was used to do X？ inspection statistical comparison. Results 28 patients （positive remodeling 23 cases, zero remodeling 1 case, and negative remodeling 4 cases）. The largest remodeling can reach to 89% an average of （23.0 ±5.7） %. Negative remodeling average is （ 12.0 ± 1.1 ） % ; There are 3 ischemic events of heart, 13 cases stem narrow in positive remodeling, The most bassoon and cavity area narrow gets to 70% ; And in 1 case of zero remodeling and 4 cases of negative remodeling there is no ischemia incident subgroup. Results Show different risk factors of different types of remodeling, and the comparison analysis has a statistical significance. Conclusion It might have relevances between stents proximal blood vessels and positive to remodel restenosis stents and remind us to make a choice discreetly of the necessary of stents.