老年冠心病患者冠状动脉支架植入术后发生支架内再狭窄的影响因素

Influencing factors of in-stent restenosis after coronary stent implantation in elderly patients with coronary heart disease

目的:分析老年冠心病患者冠状动脉支架植入术(CSI)后发生支架内再狭窄(ISR)的影响因素。方法:回顾性分析2018年12月至2020年12月于该院行CSI治疗的105例老年冠心病患者的临床资料,统计术后ISR发生率,并采用单因素分析及Logistic回归分析老年冠心病患者CSI术后发生ISR的影响因素。结果:105例老年冠心病患者CSI术后发生ISR 28例,发生率为26.67%(28/105);发生ISR者与未发生ISR者的性别、年龄、吸烟史、高血压和病变支数比较,差异均无统计学意义(P>0.05);发生ISR者与未发生ISR者合并糖尿病、支架直径、支架长度、术后抗血小板药物及他汀类降脂药物使用情况比较,差异均有统计学意义(P<0.05);合并糖尿病、支架直径<3 mm、支架长度>20 mm、术后未规律服用抗血小板药物及未使用他汀类降脂药物均为影响老年冠心病患者CSI后发生ISR的危险因素(OR>1,P<0.05)。结论:老年冠心病患者CSI后发生ISR的风险较高。合并糖尿病、支架直径<3 mm、支架长度>20 mm、术后未规律服用抗血小板药物及术后未使用他汀类降脂药物均为影响老年冠心病患者CSI后发生ISR的危险因素。

Objective:To analyze influencing factors of in-stent restenosis(ISR)after coronary stent implantation(CSI)in elderly patients with coronary heart disease.Methods:The clinical data of 105 elderly patients with coronary heart disease who underwent CSI treatment in our hospital from December 2018 to December 2020 were retrospectively analyzed.The incidence of postoperative ISR was statistically analyzed.Univariate and multivariate Logistic regression were used to analyze the influencing factors of ISR after CSI in the elderly patients with coronary heart disease.Results:ISR occurred in 28 cases in the 105 elderly patients with coronary heart disease after CSI with an incidence rate of 26.67%(28/105).There were no significant differences in gender,age,smoking history,hypertension,and number of lesions among the patients with ISR and those without ISR(P>0.05).However,there were significant differences in diabetes,stent diameter,stent length,postoperative antiplatelet drug use,and postoperative Statin lipid-lowering drug use among the patients with ISR and those without ISR(P<0.05).Combined diabetes mellitus,stent diameter<3 mm,stent length>20 mm,irregular use of antiplatelet drugs after the surgery,and no use of Statin lipid-lowering drugs after the surgery were all risk factors for ISR after CSI in the elderly patients with coronary heart disease(OR>1,P<0.05).Conclusions:Elderly patients with coronary heart disease have a higher risk of ISR after CSI.Combined diabetes mellitus,stent diameter<3 mm,stent length>20 mm,irregular use of antiplatelet drugs after the surgery,and no use of Statin lipid-lowering drugs after the surgery are all risk factors for ISR after CSI in the elderly patients with coronary heart disease.