冠状动脉药物洗脱支架置入术后再狭窄与胆红素和纤维蛋白原关系探讨

Relation of stent restenosis with serum bilirubin and fibrinogen level in CHD patients after drug eluting

目的：探讨冠状动脉药物洗脱支架术后支架内再狭窄与血清总胆红素（T B ）和纤维蛋白原（Fib ）的关系。方法收集PCI置入药物洗脱支架术后1年行冠状动脉造影随访的782例患者，分为再狭窄组130例和对照组652例。回顾性分析2组患者临床资料的差异。结果再狭窄组与无再狭窄组患者血清TB[（11．82±4．53）μmol/L vs （12．95±5．06）μmol/L]、Fib[（3．04±0．65）g/L vs （2．83±0．60）g/L]比较，差异有统计学意义（P＜0．05，P＜0.01）。支架内再狭窄与糖尿病（OR＝1.763，95％ CI：1．158～2．683）、Fib（OR＝1．678，95％ CI：1．242～2．266）呈正相关，与血清TB（OR＝0．922，95％ CI：0．860～0．988）、支架直径（OR＝0．615，95％ CI：0．444～0．850）呈负相关。结论糖尿病、Fib为支架内再狭窄的危险因素，支架直径和血清T B为支架内再狭窄保护因素。

Objective To study the relation of stent restenosis （SR） with serum bilirubin and fibrinogen level in CHD patients after drug eluting .Methods Seven hundred and eighty-two CHD patients who were followed up 1 year after PCI and drug eluting stent implantation in our hospital were divided into SR group （n=130） and control group （n=652） .Clinical data ,biochemical and coronary angiohraphy parameters about the two groups were retrospectively analyzed .Their relation with SR was analyzed by multivariate logistic regression analysis .Results The incidence of diabete mellitus （DM ） and hyperlipoidemia ,the serum level of total bilirubin and fibrinogen and the stent diameter were significantly different in the two groups （P〈 0 .05 ,P〈 0 .01） .The SR was positively related with DM and serum fibrinogen level （OR=1 .763 ,95% CI：1 .158 -2 .683 ;OR=1 .678 ,95% CI：1 .242-2.266） .However ,the SR was negatively related with the serum level of total bilirubin and stent diameter （OR=0 .922 ,95% CI：0 .860 -0 .988 ;OR= 0 .615 ,95% CI：0.444-0.850 ） .Conclusion DM and serum fibrinogen level are the risk factors for SR w hile stent diameter and serum level of total bilirubin are the protective factors for SR .