摘要
目的探讨冠状动脉支架内再狭窄的危险因素。方法选择成功施行冠状动脉支架置入并进行冠状动脉造影随访的164例冠心病患者。根据冠状动脉造影结果将其分为再狭窄组与无再狭窄组。应用单因素和Logistic多因素回归分析临床特征、冠状动脉造影特征与再狭窄的相关性。结果164例中,有172支靶血管置入支架,59例患者的63支靶血管发生再狭窄,靶血管再狭窄率为36.6%。单因素分析显示:与无再狭窄组比较,再狭窄组的冠状动脉造影随访时间短、脂蛋白(Lp)(a)浓度高、术前狭窄程度和术后残余狭窄程度重、参照血管直径和支架直径小、靶血管病变长度长(P值均<0.05)。参照血管直径<3mm的靶血管再狭窄率显著高于参照血管直径≥3mm的靶血管(P<0.05)。Logistic回归分析显示:参照血管直径、支架直径与再狭窄呈负相关(OR值分别=0.70、0.26);而术后残余狭窄、病变血管长度与再狭窄呈正相关(OR值分别=1.19、1.47)。结论冠状动脉支架术后患者发生再狭窄多在术后6个月内。支架置入术后残余狭窄重、小血管病变、长病变是支架置入术后再狭窄的独立预测因素。尽量减少支架置入术患者的术后残余狭窄是减少再狭窄的重要环节。
Objective To appraise the risk factors of restenosis after coronary stenting. Methods 164 patients successfully underwent coronary stent implantation with a follow-up study of angiography. They were di vided into restenosis group and non-restenosis group. Univariate analysis and logistic regression analysis were used to study the relationship between restenosis and factors influencing clinical and coronary angiographic char acteristics. Results In 164 patients, coronary stents were implanted for 172 target vessels. 63 target vessels from 59 patients showed demonstrable restenosis by angiography. The in-stent restenosis rate was 36.6 %. The univariate analysis showed that comparing with the non-restenosis group, the restenosis group showed more severe degree in stenosis before and after the procedure, higher concentration of LP（a）, smaller vessel diameter and longer target vessel stenosis, as well as shorter follow-up period. The restenosis rate was higher in reference vessel diameter 〈3 mm in comparing with that ≥3 mm. Logistic regression analysis revealed that there were nega- tive correlations between the stent diameter, the diameter of reference vessel before stent implantation and restenosis; and there were pnstive correlations between residual stenosis after stenting, length of target stenosis and restenosis. Conclusions Restenosis often occurs within six months after coronary stenting. Serious residual ste nosis after stenting, smaller target vessel and longer target lesion are independent risk factors of post coronary stenting restenosis. Do the best to reduce the residual stentosis during the implantation procedure may significant ly reduce the restenosis. （Shanghai Med J, 2006, 29：1-3）
出处
《上海医学》
CAS
CSCD
北大核心
2006年第1期1-3,共3页
Shanghai Medical Journal
