急性冠脉综合征患者血管内超声钙化特征与经皮冠状动脉介入术后再狭窄的影响因素

Characteristics of intravascular ultrasound calcification in patients with acute coronary syndrome and influencing factors of restenosis after percutaneous coronary intervention

目的探讨急性冠脉综合征(ACS)患者血管内超声(IVUS)钙化特征与经皮冠状动脉介入术(PCI)术后再狭窄的影响因素。方法选取2021年4月至2023年2月萍乡市第二人民医院收治的203例ACS患者作为研究对象,所有患者均接受PCI术治疗,并于PCI术后行IVUS检查,观察钙化特征,术后随访观察9个月,行术后再狭窄冠脉造影检查,依照再狭窄情况分为再狭窄组与非再狭窄组,分析钙化特征与术后狭窄发生的关系。结果203例ACS患者PCI术后9个月发生术后狭窄19例,再狭窄发生率为9.36%。再狭窄组钙化病变16例,非再狭窄组钙化病变103例,再狭窄组钙化病变发生率高于非再狭窄组,差异有统计学意义(P<0.05)。在发生钙化病变的患者中,再狭窄组中浅表型钙化类型高于非再狭窄组,钙化长度、钙化弧度大于非再狭窄组,差异有统计学意义(P<0.05)。多因素logistic回归模型分析结果显示,钙化病变(β=0.593,OR=1.809,95%CI:1.206~2.715)、钙化类型(β=0.414,OR=1.513,95%CI:1.175~1.948)、钙化长度(β=0.377,OR=1.458,95%CI:1.189~1.788)、钙化弧度(β=0.185,OR=1.203,95%CI:1.055~1.372)是ACS患者PCI术后再狭窄发生的独立影响因素(P<0.05)。结论ACS患者钙化病变的发生可导致其PCI术后再狭窄风险增加,且与钙化类型、钙化长度及钙化弧度相关。

Objective To investigate the characteristics of intravascular ultrasound(IVUS)calcification and the influencing factors of restenosis after percutaneous coronary intervention(PCI)in patients with acute coronary syndrome(ACS).Methods A total of 203 patients with ACS admitted to Pingxiang NO.2 People's Hospital from April 2021 to February 2023 were selected as the study objects.All patients received PCI treatment,and underwent IVUS examination after PCI to observe the calcification characteristics,followed up for 9 months,and underwent postoperative restenosis coronary angiography.According to restenosis,the patients were divided into restenosis group and non-restenosis group,and the relationship between calcification and postoperative stenosis was analyzed.Results Among 203 patients with ACS,postoperative stenosis occurred in 19 cases 9 months after PCI,and the incidence of restenosis was 9.36%.There were 16 cases of calcification in the restenosis group and 103 cases in the non-restenosis group.The incidence of calcification in the restenosis group was higher than that in the non-restenosis group,and the difference was statistically significant(P<0.05).In the patients with calcification,the type of superficial calcification in the restenosis group was higher than that in the non-restenosis group,and the length and arc of calcification were higher than those in the non-restenosis group,with statistical significance(P<0.05).Multivariate logistic regression model analysis showed that calcification lesion(β=0.593,OR=1.809,95%CI:1.206-2.715),calcification type(β=0.414,OR=1.513,95%CI:1.175-1.948),calcification length(β=0.377,OR=1.458,95%CI:1.189-1.788)and arc of calcification(β=0.185,OR=1.203,95%CI:1.055-1.372)were the independent influencing factors for restenosis in ACS patients after PCI(P<0.05).Conclusion The occurrence of calcification in ACS patients can increase the risk of restenosis after PCI,and it is related to the type,length and arc of calcification.