高龄患者冠脉支架植入术后再狭窄相关危险因素分析

Analysis of risk factors associated with restenosis after coronary stent implantation in elderly patients

目的探讨高龄患者冠脉支架植入术后再狭窄的相关危险因素,为临床防治提供参考。方法选取2014年8月~2017年8月来我院复查的242例高龄冠脉支架植入患者作为研究对象,根据复查冠脉造影结果,将其中原支病变再狭窄的30例患者作为再狭窄组,其余212例未发生狭窄的患者作为未狭窄组,对两组患者相关因素进行单因素和多因素非条件Logistic回归分析。结果单因素分析结果显示合并2型糖尿病、吸烟、危险因素个数、术前狭窄程度、血清总胆红素水平、血小板计数、植入支架直径及术后规律服药与冠脉支架植入术后再狭窄具有相关性,差异有统计学意义(P<0.05);多因素非条件Logistic回归分析显示合并2型糖尿病、危险因素个数及植入支架直径是高龄患者冠脉支架植入术后再狭窄的独立危险因素,而血清总胆红素水平和术后规律服药是其保护因素。结论对影响高龄患者冠脉支架植入术后再狭窄的相关危险因素积极进行干预,对预防高龄患者冠脉支架植入术后再狭窄有重要的临床意义。

Objective To explore the related risk factors of restenosis after coronary stent implantation in elderly patients, provide the reference for clinical. Methods 242 cases of elderly patients with coronary stent implantation accepted re-examination from Aug 2014 to Aug 2017 were analyzed, there were 30 cases of patients with restenosis as restenosis group, the rest of 212 patients were as no restenosis group, single factor and nonconditional Logistic regression analysis were performed in both groups. Results Single factor analysis showed that type 2 diabetes mellitus, smoking, amount of risk factors, preoperative stenosis, serum total bilirubin level, platelet count, stent diameter and postoperative medication were closely related to restenosis after coronary stent implantation, the differences were statistically significant (P< 0.05). Multiple factors of the unconditioned Logistic regression analysis showed that type 2 diabetes mellitus, amount of risk factors and stent diameter were independent risk factors of restenosis after coronary stent implantation, serum total bilirubin level and postoperative medication were protective factors. Conclusion Positive intervention measures for risk factors of restenosis after coronary stent implantation in elderly patients has important clinical significance for the prevention of restenosis after coronary stent implantation.