关键词：冠状动脉疾病；支架；再狭窄
【摘要 】 目的 分析与冠状动脉内支架再狭窄有关的临床和血管造影及其处理因素。方法 回顾性分析了在我院成功冠状动脉内支架置入和6个月后有冠状动脉造影随访的74例病人的临床和血管造影及处理资料。用单因素和多因素回归分析方法分析了病人年龄、冠心病易患因素、靶病变形态学、及术后最小管腔开放直径(MLD)等32个变量与再狭窄的关系。结果 在单因素分析中发现：术前血管参照直径和术后MLD在再狭窄组明显低于非再狭窄组(3.1±0.3 mm vs3.3±0.4 mm和2.9±0.4 vs 3.2±0.4 mm (P<0.05 和0.01)。支架直径小于3.5 mm组的再狭窄率明显高于支架直径大于3.5 mm组的再狭窄率(41.7% vs 10.8%, P<0.05)。多元Logistic回归分析发现: 术后支架管腔MLD、支架直径<3.5 mm、吸烟和高龄是再狭窄的独立危险因素。结论 术后支架管腔MLD、支架直径<3.5 mm、吸烟和高龄是最重要的支架再狭窄的独立危险因素。
Multivariateanalysis of post-stenting coronary restenosis
Guo Jingxuan, Mao Jieming, Guo Lijun, et al. Third Teaching Hospital Cardiology Division, Beijing Medical University , Beijing 100083
【Abstract 】 Objective To study the relationship between post -stenting coronaryrestenosis and its relevant clinical, angiographic and procedural factors.Methods The data of 74 patients who successfully underwentcoronary stent implantation and six-month angiographic follow-up were analyzedretrospectively. We used univariate and multivariate analysis to study the relationshipbetween restenosis and 32 other factors including patient′s age,risk factors for coronary heart disease , morphologiccharacteristics of target lesions and postprocedural minimal luminal diameter (MLD), etc. Results Univariate analysis revealed that the reference-vesseldiameter and post-stenting MLD in the restenosis group were significantly smaller than inthe non-restenosis group (
3.05±0.31 mm vs 3.26±0.39mm, P<0.05 and 2.94±0.36 mm vs 3.22±0.37 mm P<0.01, respectively). The restenosis rate was higher in thesubset of patients with stent diameter <3.5 mm compared to those with stent diameter>3.5 mm (47.7% vs 10.8%, P<0.05). Multivariate analysis revealed that post-stentingMLD,stent diameter <3.5 mm, smoking and age were the independent risk factors forcoronary post-stenting restenosis. Conclusion postprocedural MLD, smoking, stent diameter <3.5 mm and old ageare the most important independent risk factors for coronary post-stenting restenosis.......
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