摘要
目的 评价贫血与冠状动脉支架植入术后再狭窄的关系。方法 采用巢式病例对照研究的方法,单中心纳入2021年1月1日至12月31日接受冠状动脉支架植入术的患者,对患者随访至2024年6月30日。根据患者是否存在贫血分为贫血组(76例)和非贫血组(248例),比较两组患者冠状动脉再狭窄发生情况。门诊和电话随访294例患者中,再狭窄组53例,非再狭窄组241例。比较两组患者的临床基线资料和介入治疗资料,采用Logistic回归分析老年冠状动脉支架植入术后患者再狭窄的影响因素。对老年冠状动脉支架植入术后患者的血红蛋白水平和Framingham评分进行相关性分析。ROC曲线分析贫血对再狭窄的预测价值。结果 Kaplan-Meier生存曲线显示,术后发生再狭窄患者,贫血组25例,非贫血组28例,RR(relative risk)为2.914,贫血组患者累积再狭窄率高于非贫血组,Log-rank检验χ^(2)=22.986(P<0.01),再狭窄组年龄、低密度脂蛋白胆固醇(LDL-C)、吸烟史比率高于非再狭窄组,血红蛋白(Hb)、肾小球滤过率(GFR)低于非再狭窄组。患者血红蛋白浓度与弗明汉评分(r=0.868,P<0.001)呈负相关,ROC曲线分析显示,老年患者Hb对冠状动脉支架植入术后再狭窄预测的AUC为0.892,敏感度83.3%,特异度90.0%,截断值为118 g/L。结论 贫血与冠状动脉支架植入术后患者再狭窄风险显著相关,低血红蛋白对再狭窄有良好的预测价值。
Objective To evaluate the relationship between anemia and restenosis after coronary artery stenting.Methods A nested case-control study was conducted in which patients who underwent coronary artery stenting from January 1 to December 31,2021 were enrolled at a single center and followed up until June 30,2024.According to whether the presence of anemia,the patients were divided into the anemia group(76 cases)and non-anemia group(248 cases),and the occurrence of coronary artery restenosis was compared between the two groups.Outpatient and telephone follow-up of 294 patients included 53 patients in the stenosis group and 241 patients in the non-restenosis group.The clinical baseline data and interventional therapy data of the two groups were compared,and Logistic regression was used to analyze the influencing factors of restenosis in elderly patients after coronary artery stenting.The correlations between hemoglobin levels and Framingham scores were performed in elderly patients after coronary stenting.ROC curves were used to analyze the predictive value of anemia for restenosis.Results Kaplan-Meier survival curves showed that there were 25 patients with restenosis in the anemia group and 28 patients in the non-anemia group,RR(relative risk)was 2.914.The cumulative restenosis rate in the anemia group was higher than that in the non-anemia group(Log-rank testχ^(2)=22.986,P<0.01).The age,low-density lipoprotein cholesterol(LDL-C)and smoking history rate in the restenosis group were higher than those in the non-restenosis group,and hemoglobin(Hb)and glomerular filtration rate(GFR)were lower than those in the non-restenosis group.The hemoglobin concentration was negatively correlated with Framingham score(r=0.868,P<0.001).ROC curve analysis showed that the AUC of Hb for predicting restenosis after coronary artery stenting in elderly patients was 0.892,the sensitivity was 83.3%,the specificity was 90.0%and the cutoff value was 118 g/L.Conclusion Anemia is significantly associated with the risk of restenosis in elderly patients after coronary artery stenting,and low hemoglobin has a good predictive value for restenosis.
作者
陈文韬
秦牧
杜坤
徐广
冯秀元
CHEN Wen-tao;QIN Mu;DU Kun;XU Guang;FENG Xiu-yuan(Department of Cardiology,The Ezhou Central Hospital,Ezhou 436000,China;Department of Cardiology,Shanghai Chest Hospital,Shanghai 200030,China)
出处
《中国心血管病研究》
2025年第10期943-948,共6页
Chinese Journal of Cardiovascular Research
关键词
贫血
支架术后再狭窄
巢式病例对照研究
Anemia
Restenosis after coronary stent
Nested case-control study
