血清TB与Fib对冠心病患者药物洗脱支架置入术后再狭窄影响的研究

THE RESEARCH ON THE EFFECT OF SERUM TB AND FIB TO DRUG-ELUTING STENTS RESTENOSIS AFTER SURGERY OF PATIENTS WITH CORONARY HEART DISEASE

目的探究冠心病患者药物洗脱支架置入术后发生再狭窄的影响因素,探讨有效的预防措施。方法选取2009年1月—2013年12月在该院接受药物洗脱支架置入术的冠心病患者60例。比较再狭窄组和正常组患者的临床资料,用单因素分析和Logistic多元回归分析其影响因素。结果所有患者均于经皮冠状动脉介入治疗术后1年时复查冠状动脉造影,60例患者中有10例发生支架内再狭窄,发生率为16.67%。将患者的年龄、性别、高血压、高血脂、糖尿病、陈旧性心肌梗死、吸烟、LVEF、TC、TG、LDL、HDL、ALT、AST、TB、Fib、多支病变、血管病变部位、置入支架直径、置入支架长度、置入支架数量等作为自变量,术后是否发生支架内再狭窄作为因变量,进行单因素分析。结果显示,性别、高血脂、糖尿病、Fib、TB、置入支架直径是行经皮冠状动脉介入治疗患者术后发生支架内再狭窄的影响因素,以上差异均有统计学意义(P<0.05);年龄、高血压、吸烟、陈旧性心肌梗死、LVEF、TC、TG、LDL、HDL、AST、ALT、多支病变、血管病变部位、置入支架长度、置入支架数量不是行经皮冠状动脉介入治疗患者术后发生支架内再狭窄的影响因素,以上差异无统计学意义(P>0.05)。将患者是否发生支架内再狭窄作为因变量,将性别、高血脂、糖尿病、Fib、TB、置入支架直径作为自变量进行Logistic回归分析,结果显示糖尿病、Fib、TB、置入支架直径是行经皮冠状动脉介入治疗患者术后支架内再狭窄的独立影响因素,其中较高TB水平、较大的支架直径是保护因素,Fib、糖尿病是危险因素。随着病变支数的增多,患者TB水平呈下降趋势,Fib水平呈上升趋势,组间比较差异有统计学意义(P<0.05)。结论糖尿病、Fib、TB、置入支架直径是冠心病患者药物洗脱支架置入术后发生再狭窄的影响因素。

Objective To explore the affecting factors of having drug-eluting stents restenosis after surgery of patients with coronary heart disease,and to find effective prevention measures.Methods Totally60 cases of patients with coronary heart disease（CHD）receiving drug-eluting stents（des）surgery in author＇s hospital between January 2009 and December 2013 were chosen.Compared the clinical data of patients with restenosis group and normal group,univariate and multivariate logistic regression was used to analyze the influence factors.Results All of the patients were reviewed coronary angiography in percutaneous coronary intervention in postoperative 1 year,10 patients of 60 cases had stent restenosis,the rate was 16.67%.Patient＇s age,gender,hypertension,hyperlipidemia,smoking,diabetes,chronic myocardial infarction,LVEF,TC,TG,LDL,HDL,ALT,AST and TB,Fib,multivessel lesions and vascular lesions,in diameter,length of placing stents,stent placement support number were as independent variable,whether having stent restenosis after surgery as dependent variable,single factor analysis results showed that gender,high cholesterol,diabetes,Fib,TB,placing stents diameter were influence factors of stent restenosis of suffer occurred postoperatively in patients with coronary artery intervention treatment,the above differences had statistical significance（P〈0.05）;While age,hypertension,smoking,chronic myocardial infarction,LVEF,TC,TG,LDL,HDL,AST,ALT,multivessel lesions and vascular lesions,placing stents length,number of placing stents were not influence factors of stent restenosis of suffer occurred postoperatively in patients with coronary artery intervention treatment,the above differences had no statistical significance（P〉0.05）.Taking whether patients would happen stent restenosis as dependent variable,the sex,high cholesterol,diabetes,Fib,TB,placing stents diameter as the independent variable,logistic regression analysis results showed that diabetes,Fib,TB,placing stents diameter were independent influencing factors of stent restenosis after suffer coronary artery intervention treatment,among them higher level of TB,the larger diameter were the protection factor;Fib,diabetes were risk factor.Along with the increase in lesion counts,patients with TB level was on the decline,Fib level was on the rise,the above differences had statistical significance（P〈0.05）.Conclusion Diabetes,Fib,TB,placing stents diameter were the influence factors of restenosis after carotid stenting.drug-eluting coronary heart disease patients.