药物洗脱支架置入后支架内血栓形成患者的临床特征分析

Clinical characteristic analysis of stent thrombosis in patients underwent drug eluting stent implantation

目的:分析药物洗脱支架(DES)置入术后支架内血栓形成(ST)的相关危险因素。方法:回顾性分析我院2013年1月至2016年6月间,因急性冠状动脉综合征(ACS)接受DES置入术的患者的临床资料,将术后发生ST的81例患者作为实验组,并按年龄、性别匹配同期未出现ST的患者243例(1∶3)作为对照组。比较两组临床资料,应用条件Logistic回归模型对支架内血栓形成进行风险评估。结果:条件Logistic回归分析确定DES置入术后ST的独立危险因素为:自身免疫性疾病(OR=120.078,95%CI=1.386~10404.459,P=0.035)、首发为急性心肌梗死(OR=14.085,95%CI=2.215~89.573,P=0.005)、左心室射血分数(LVEF)<50%(OR=19.985,95%CI=2.945~135.630,P=0.002)、空腹血糖(OR=1.977,95%CI=1.281~3.053,P=0.002)。结论:研究提示,自身免疫性疾病、首发为急性心肌梗死、LVEF<50%、空腹血糖升高是DES置入术后发生ST的独立危险因素。

Objective： To analyze the related risk factor of stent thrombosis （ST） in patients who un- derwent drug eluting stent （DES） implantation. Methods： We retrospectively analyzed the clinical charters of acute coronary syndrome （ACS） patients undergoing DES implantation between January 2013 and June 2016. 81 patients who suffered from ST after stenting were included in experiment group, while 243 patients who had no ST at the same time were matched by age or gender （ 1 ： 3 ） as control group. The clinical data between the two groups were compared and the conditional logistic regression model was performed to carry out risk assess- ment. Results： Conditional logistic regression analysis indicated that the independent risk factors for ST includ- ed ： autoimmune diseases （ OR = 120. 078,95% CI = 1. 386 ~ 10404. 459, P = 0. 035）, acute myocardial infarc- tion as the initial onset（ OR = 14. 085,95% CI = 2. 215 - 89. 573 ,P = 0. 005 ）, left ventricular ejection fraction 〈 50% （ OR = 19. 985,95% CI = 2. 945 - 135. 630, P = 0. 002）, fasting blood glucose （ OR = 1. 977,95% C1 = 1.281 -3. 053,P = 0. 002）. Conclusion： The present study revealed that autoimmune diseases, acute myo- cardial infarction as the initial onset, left ventricular ejection fraction 〈 50% and high fasting blood glucose are independent risk factors for ST following DES implantation.