摘要
目的 分析冠脉内支架植入术后再狭窄的危险因素。方法 自 1996年 1月至 2 0 0 0年 9月 10 2 5例冠脉内支架植入术患者中 ,10 1例因胸痛复发或由于医生动员而行冠脉造影随访 ,记录这些患者的冠心病易患因素 ,对病变狭窄程度及长度用QCA测定 ,以支架植入节段内径≥ 5 0 %为再狭窄。结果 10 1例患者共 12 2处病变植入支架 ,造影显示支架内再狭窄 5 2例 (6 2处病变 )。多因素逐步回归分析显示 ,再狭窄与血浆胆固醇 ,Lp(a) ,尿酸浓度、术前狭窄程度、术后残余狭窄呈正相关 ,其比数比(OR)分别为 1.2 1、1.94、1.13、1.0 7和 1.6 3;与术前参考血管直径和支架呈显著负相关 ,OR分别为 0 .2 4和 0 .31。结论 冠脉内支架植入术后再狭窄受多因素的影响 ,控制血脂 ,避免冠脉内小支架应用以及术后即刻疗效满意对减低冠脉内支架植入术后再狭窄具有重要作用。
Objective To analyse the risk factors of restenosis after coronary stenting.Methods In 1 025 cases who underwent coronary stenting between January 1996 and September 2000, follow up coronary angiography was performed in 101 patients due to chest pain or doctor's advise. Risk factors for coronary artery disease were recorded. The degree of stenosis and length of lesions were measured by QCA. Results In 101 patients, coronary stents were implanted for 122 lesions. In stent restenosis (luminal narrowing ≥50%) occurred in 62 lesions of the 52 patients. Logistic regression analysis revealed stent restenosis correlated positively correlated closely with plasma levels of cholesterol (OR 1.21), Lp(a) (OR 1.94),uric acid(OR 1.13) and degree of coronary stenosis before the procedure (OR 1.07) and residual stenosis after stenting (OR 1.63). It was inversely proportional to the diameter of reference vessel (OR 0.24) and stents (OR 0.31). Conclusions The occurrence of restenosis after coronary stenting may be influenced by multiple factors. Controlling plasma lipid profile, avoiding small coronary stents and obtaining better results immediately after procedure are crucial for the reduction of overall restenosis rate.
出处
《介入放射学杂志》
CSCD
2001年第2期75-77,共3页
Journal of Interventional Radiology
