冠状动脉雷帕霉素涂层支架植入术后支架内再狭窄临床预测因素探讨

发布时间：2018-04-21 22:19

本文选题：氧化型低密度脂蛋白 + 同型半胱氨酸　；参考：《介入放射学杂志》2017年10期

【摘要】：目的分析氧化型低密度脂蛋白(ox-LDL)、同型半胱氨酸(Hcy)与冠状动脉支架内再狭窄(ISR)的关系,探讨雷帕霉素涂层支架植入后ISR临床预测因素。方法入选400例冠状动脉雷帕霉素涂层支架植入患者,根据冠状动脉复查造影结果分为ISR组和无ISR组。术前及复查造影时检测血浆ox-LDL、Hcy水平。采用多元Logistic回归分析评价ISR相关临床参数、血管造影特征及手术相关因素。结果 ISR组48例,无ISR组352例,临床ISR发生率为13.6%。与无ISR组比较,ISR组患者支架植入术前、冠状动脉复查造影时血浆ox-LDL、Hcy水平明显升高,差异均有统计学意义(P0.05)。多元Logistic回归分析结果显示,伴高血压病、伴糖尿病、Hcy、ox-LDL、服用他汀类药物、吸烟、冠状动脉开口病变、冠状动脉分叉病变、慢性完全闭塞病变、参考血管直径、术前血管狭窄程度、植入支架直径、植入支架长度为ISR独立相关因素。结论冠状动脉雷帕霉素涂层支架植入后ISR并不少见。伴高血压、伴糖尿病、Hcy、ox-LDL、吸烟、冠状动脉开口病变、冠状动脉分叉病变、慢性完全闭塞病变、术前血管狭窄程度、参考血管直径、植入支架直径、植入支架长度为ISR独立相关因素。长期规律服用他汀类药物可降低ISR风险。
[Abstract]:Objective to analyze the relationship between oxidized low density lipoprotein (ox-LDL), homocysteine (HCH) and restenosis in coronary stents, and to explore the clinical prognostic factors of ISR after rapamycin coated stent implantation. Methods 400 patients with rapamycin-coated stent implantation were divided into ISR group and no ISR group. Plasma ox-LDL- Hcy levels were measured before and after reexamination. Multivariate Logistic regression analysis was used to evaluate the clinical parameters, angiographic features and operative factors related to ISR. Results there were 48 cases in ISR group and 352 cases in non-ISR group. The incidence of clinical ISR was 13. 6%. Compared with the control group, the plasma ox-LDL- Hcy level was significantly increased before stent implantation in the ISR group, and the difference was statistically significant (P 0.05). Multivariate Logistic regression analysis showed that patients with hypertension and diabetes mellitus had Hcyox-LDL, statins, smoking, coronary artery disease, coronary artery bifurcation, chronic total occlusion, reference vessel diameter, and preoperative stenosis. The diameter of stent and the length of stent were independent factors of ISR. Conclusion ISR is not uncommon after coronary artery rapamycin-coated stent implantation. With hypertension, diabetes mellitus with Hcyox-LDL, smoking, coronary artery opening lesion, coronary artery bifurcation lesion, chronic total occlusion disease, preoperative vascular stenosis degree, reference vessel diameter, stent diameter, The length of stent was an independent factor of ISR. Long-term regular use of statins can reduce the risk of ISR.
【作者单位】：广西医科大学第三附属医院心内科;
【分类号】：R541.4

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