冠心病患者支架置入术后再狭窄原因的临床研究

Clinical Study of the Reason of In-stent Restenosis after Percutaneous Coronary Intervention on the Coronary Heart Disease Patients

目的通过对经皮冠状动脉介入术后复查冠状动脉造影患者的回顾性分析,研究引起支架内再狭窄(ISR)的可能原因。方法入选我院2008—2011年所有复查造影的冠心病支架治疗患者210例,平均年龄(68.9±7.8)岁;男125例,女85例,将其分成支架内再狭窄组和无再狭窄组,分析两组间可能导致支架内再狭窄的因素。结果 210例患者共置入352枚支架,其中有37枚支架发生再狭窄(支架内再狭窄定义为随访时造影提示支架内管腔内径损失≥50%)。分析两组临床资料特征及支架长度、直径,是否为药物涂层支架等因素;支架内再狭窄组及无再狭窄组在脂蛋白(a)、支架长度、和药物/非药物支架方面有显著差异(P<0.05)。Cox比例风险回归模型显示仅支架长度(P=0.007)、直径(P=0.022)和药物/非药物支架(P=0.036)为冠心病介入患者发生ISR的预测因子。结论冠状动脉支架置入后发生再狭窄的主要原因为支架长度、直径及是否为药物支架。

Objective Through following-up patients who accepted PCI（percutaneous coronary intervention）therapy rechecked CAG（coronary angiography） to analysis the possible reasons of in-stent restenosis（ISR）.Methods 210 cases which were coronary heart disease（CHD） patients who underwent CAG after PCI therapy from 2008 and 2011 are enrolled.All these cases are divided into two groups according to CAG which are restenosis group and non-restenosis group.Then compare the possible reasons for restenosis between the two groups.Results 352 stents were implanted in 210 patients.37 stents had restenosis.We found that there were significantly different between restenosis group and non-restenosis group in lipoprotein（a）（Lp（a））,the length and diameter of stent and whether the stent is drug-eluted or not（P〈0.05）.Cox proportional hazards regression model showed that the length（P=0.007）and diameter of stent（P=0.022） and whether the stent is drug-eluted or not（P=0.036）Were independent prognosis factors of ISR.Conclusion The primary reasons of ISR are the length and diameter of stent and whether the stent is drug-eluted or not.