血脂控制水平与支架置入术后冠脉支架内再狭窄的相关性研究

发布时间：2017-12-31 11:15

本文关键词：血脂控制水平与支架置入术后冠脉支架内再狭窄的相关性研究　出处：《兰州大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的本研究通过分析冠心病患者行PCI术前血脂水平与术后3-12月期间再次复查时血脂水平,探讨血脂控制水平与冠状动脉介入治疗术后支架内再狭窄的相关性。方法收集2012年1月至2012年12月在兰州大学第一医院心脏中心住院首次行PCI的冠心病患者211例,所有患者均常规口服双联抗血小板、他汀类药物,并于术后3月至12月再次入院行冠状动脉造影,根据造影结果分为两组,其中再狭窄组25例,无再狭窄组186例,所有入选患者于PCI术前及复查造影时采集外周静脉血,使用全自动生化分析仪检测总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白,定量分析两次血脂水平,探讨其与冠脉支架内再狭窄的关系。结果两组患者中年龄、性别、高血压患病率、冠心病家族史、术前诊断急性冠脉综合症(Acute coronary syndrom,ACS)、吸烟、饮酒比例差异均无统计学意义P0.05),PCI术前总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白水平差异均无统计学意义(P0.05)；合并糖尿病患者再狭窄组(9/25)较无再狭窄组(33/186)差异有统计学意义(P=0.03)；经Logistic多因素逐步回归分析显示低密度脂蛋白未控制在1.8mmol/L以下或较前未下降50%(比值比=0.09,95%可信区间：0.03-0.28,P0.01)、总胆固醇未下降(比值比=3.83,95%可信区间：1.07-13.62,P=0.04)、合并糖尿病(比值比=0.33,95%可信区间：0.11-0.94,P=0.04)与支架内再狭窄有正相关性。结论冠心病患者行PCI术后,常规口服双联抗血小板聚集、他汀类药物治疗,总胆固醇未下降、低密度脂蛋白未达标是后期支架内再狭窄发生的高危因素,合并糖尿病患者行PCI术后发生支架内再狭窄的几率明显增高。
[Abstract]:Objective to analyze the serum lipid levels before and after PCI in patients with coronary heart disease (CHD). To investigate the correlation between blood lipid control level and stent restenosis after coronary intervention. Methods PC was performed for the first time from January 2012 to December 2012 in the heart center of the first Hospital of Lanzhou University. There were 211 patients with coronary heart disease. All patients were routinely given dual antiplatelet and statins, and were re-admitted to hospital from March to December. According to the results of coronary angiography, they were divided into two groups, including 25 patients in restenosis group. In the non-restenosis group, peripheral venous blood was collected before and after PCI, and total cholesterol, triglyceride and high density lipoprotein were detected by automatic biochemical analyzer. Low density lipoprotein (LDL), quantitative analysis of blood lipid levels twice, to explore its relationship with coronary stent restenosis. Results the two groups of patients in age, sex, prevalence of hypertension, coronary heart disease family history. There was no significant difference in the proportion of smoking and drinking in the diagnosis of acute coronary syndrome before operation (P 0.05). There was no significant difference in total cholesterol, triglyceride, high density lipoprotein and low density lipoprotein before PCI. There was a statistically significant difference between the restenosis group (n = 9 / 25) and the non-restenosis group (n = 33 / 186). Logistic multivariate stepwise regression analysis showed that LDL was not controlled below 1.8 mmol / L or did not decrease by 50% (ratio = 0.09). The confidence interval of 95%: 0.03-0.28% P0.01g, total cholesterol did not decrease (the ratio was 3.83% 95% CI: 1.07-13.62% P0.04). There was a positive correlation between the ratio of diabetes mellitus (0.33% 95% CI: 0.11-0.94) and restenosis in stent. Conclusion patients with coronary heart disease underwent PCI operation. Routine oral dual anti-platelet aggregation, statins drug treatment, total cholesterol did not decrease, low density lipoprotein is not up to standard is the risk factor of restenosis in stent. The incidence of stent restenosis after PCI was significantly increased in patients with diabetes mellitus.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R541.4

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