冠状动脉支架植入后即刻非支架节段内冠状动脉痉挛的临床特点

Clinical Characteristics of Patients with Immediate Severe Coronary Artery Spasm after Stent Implantation

目的:探讨冠状动脉支架植入后即刻非支架节段内冠状动脉痉挛的临床特点。方法:回顾分析2012年1月—2013年12月于复旦大学附属中山医院心内科接受经皮冠状动脉介入治疗的6918例患者的临床资料,其中术中记录且经冠状动脉造影证实的支架植入后即刻非支架节段内冠状动脉痉挛患者共102例,选择同期接受支架植入但未发生冠状动脉痉挛且年龄和性别匹配的患者共204例作为对照组。比较2组患者的一般资料、血液学检查指标及平均植入支架数目和植入支架总长度。结果:冠状动脉痉挛组男性比例、高脂血症病史比例及目前吸烟比例显著高于对照组(P<0.05);中性粒细胞计数、超敏C反应蛋白水平显著高于对照组(P<0.05);平均植入支架数目多于对照组植入支架总长度显著长于对照组(P<0.05)。结论:冠状动脉支架植入后即刻非支架节段内冠状动脉痉挛多发生于男性和吸烟患者,过多、过长的支架植入可能诱发冠状动脉痉挛,慢性炎性反应可能在冠状动脉痉挛的发生过程中起重要作用。

Objective：To analyze the clinical characteristics of patients with immediate severe coronary artery spasm（CAS）after stent implantation.Methods：The clinical data of 6918 patients who received percutaneous coronary intervention（PCI）from Jan 2012 to Dec 2013 in Zhongshan Hospital,Fudan University were retrospectively analyzed.And 102 patients with immediate severe CAS after stent implantation were identified and204 age-and gender-matched patients without immediate severe CAS after stent implantation were selected as control subjects.The general information,blood indexes,number and length of stents in the two groups were compared.Results：Compared with the control group,the ratios of males,smoking and dyslipidemia were higher in CAS group（P〈0.05）.Patients with CAS had higher neutrophil count and higher level of high sensitive C-reactive protein（P〈0.05）and received more and longer stents implantation than the control group（P〈0.05 or 0.01）.Conclusions：Male patients and patients with history of smoking are prone to have immediate severe CAS after stent implantation.Moreover,patients with more and longer stents implantation are prone to have immediate severe CAS.Inflammation may play an important role in the development of CAS after stent implantation.