冠状动脉支架置入后再狭窄的相关因素分析

Analysis of the Related Factors of In-stent-restenosis after Coronary Stent Implantation

目的探讨经皮冠状动脉支架置入术(percutaneous coronary intervention,PCI)后支架内再狭窄的相关因素。方法收集2015年12月~2016年11月在笔者医院行冠状动脉造影随访冠状动脉支架的患者76例,按照支架情况分为冠状动脉支架再狭窄组(ISR组)和无冠状动脉支架再狭窄组(no ISR组),比较两者患者的性别、年龄、体重指数(BMI)、糖尿病史、高血压史、吸烟史、支架位置、支架直径、支架长度、支架置入时间、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)、甘油三酯、总胆固醇及血清总胆红素,并采用Logistic回归对相关因素进行分析。结果两组资料进行对比,ISR组患者年龄大,支架置入时间长,但发生在右冠状动脉的概率较低。Logistic多因素回归分析显示BMI、支架直径、支架长度、支架置入时间及甘油三酯是ISR发生的危险因素,右冠状动脉是ISR的保护因素。结论冠状动脉支架置入术后ISR的发生与多个临床因素及介入学因素相关,有效的控制危险因素,对预防ISR的发生以及冠状动脉支架置入术后患者的预后有至关重要的意义。

Objective To investigate the related factors of stent restenosis after coronary stent implantation （PCI）.Methods Seventy six patients in our hospital from December 2015 to November 2016 who accepted coronary angiography were divided into two groups：in stent restenosis group （ISR group） and non restenosis group （no ISR group）.We compared the two groups with sex, age and body mass index （BMI）, history of diabetes, history of hypertension, smoking history, stent position, stent diameter, stent length, stent implantation time, low density lipoprotein （LDL）, high density lipoprotein （HDL）, triglyceride, total cholesterol, serum bilirubin. And we analyzed the related factors of ISR by logistic analysis.Results The age of patients in ISR group were older. The stent implantation time was longer, and the risk of ISR for the right coronary artery was lower. Logistic multivariate regression analysis showed that BMI, stent diameter, stent length, stent implantation time and triglyceride were the risk factors for ISR, and the right coronary stenting was the protective factor of ISR.Conclusion The incidence of ISR after coronary stent implantation related with multiple clinical factors and intervention factors. Effectively controlling the risk factors is crucial to prevent the occurrence of ISR.