冠状动脉支架内再狭窄的相关因素分析

Clinical evaluation of risk factors on coronary in-stent restenosis

目的 探讨可能引起支架内再狭窄的临床及支架相关因素。方法 选择随访的冠状动脉造影资料较全的 137例支架术后患者。依冠状动脉造影结果将其分为支架内再狭窄组和非再狭窄组 ,然后对可能引起支架内再狭窄的临床和支架相关因素在两组中进行对比分析。结果 两组年龄、吸烟、饮酒等情况相似 ,高血压病及糖尿病的发生率差异无显著性。再狭窄组术前靶血管狭窄程度较非再狭窄组重 ,分别为 91%± 7%和 88%± 14% (P =0 0 33)。再狭窄组所选支架的平均直径较非再狭窄组的小 ,分别为 (3 19± 3 90 )mm和 (3 6 3± 0 30 )mm(P =0 0 0 5 ) ;支架长度却较非再狭窄组的长 ,分别为 (2 1 91± 8 98)mm和 (18 2 0± 6 0 7)mm(P =0 0 11)。再狭窄组的支架扩张总时间明显短于非再狭窄组 ,分别为 (2 2 74± 19 5 6 )s和 (2 9 12± 2 5 72 )s(P =0 0 2 6 )。两组的支架扩张次数和扩张压力差异无显著性。结论 本文资料提示年龄、吸烟、饮酒、高血压病、糖尿病、支架扩张次数及压力的大小等因素对支架内再狭窄无明显影响 ,但术前靶血管狭窄程度和支架长度与支架内再狭窄呈正相关 ,而支架直径和支架扩张总时间则呈负相关。

Objective To evaluate the clinical and stenting relating risk factors on the in-stent restenosis. Methods One hundred and thirty seven patients whose data were available were enrolled in this study, and the patients were divided into the groups of in-stent restenosis and non in-stent restenosis according to the results of coronary angiograms. Then the clinical and stent relating factors affecting in-stent restenosis were analyzed. Results There were no statistical differences in age and prevalence of smoking, drinking, hypertension and diabetes mellitus between two groups. Narrowing of target coronary vessels before the procedures in the group of in-stent restenosis was more severe than that in the group of non in-stent restenosis ( vs , P=0.033). The average diameter of stents used in the group of in-stent restenosis was obviously smaller than that used in the group of non in-stent restenosis ([3.19±3.90]mm vs mm, P=0.005), the average length of stents, however, used in the group of in-stent restenosis was apparently longer than that used in the group of non in-stent restenosis ([21.91±8.98]mm vs [18.20±6.07]mm, P=0.011). The total duration of stent inflation in the group of in-stent restenosis was obviously shorter than that in the group of non in-stent restenosis ([22.74±19.56]s vs [29.12±25.72]s, P=0.026). There was no statistial difference between the two groups in the inflation times and pressure of stents implantation. Conclusion The results suggested that the rate of in-stent restenosis was not significantly influenced with age, smoking, drinking, hypertension, diabetes mellitus and inflation times and pressure of stent implantation, but the narrowing of target vessels before procedures and the lengths of the stents were positively related to in-stent restenosis, while stent diameters and total inflation durations of stent were negatively related to in-stent restenosis.