冠心病患者药物支架内再狭窄的影响因素分析

发布时间：2018-11-29 07:39

【摘要】：目的分析冠心病患者药物支架内再狭窄(ISR)的影响因素,为预防ISR提供理论指导。方法对2014年5月至2015年5月期间行经皮冠状动脉成形术的300例患者随访6~12个月并复查冠脉造影,分析两组患者的临床资料,采用多因素Logistic回归分析ISR的危险因素。结果 ISR组低密度脂蛋白、糖化血红蛋白、载脂蛋白b、超敏C反应蛋白水平、植入支架数量及支架长度、心肌桥及分叉病变发生率高于无ISR组(P0.05);ISR组支架直径明显小于无ISR组(2.58±0.52 vs.2.98±0.48,P0.001)。ISR组阿司匹林、氯吡格雷及他汀类药物使用率高于非ISR组(P0.05)。多因素Logostic回归分析显示糖化血红蛋白、超敏C反应蛋白、低密度脂蛋白、载脂蛋白b、心肌桥、分叉病变等是ISR的危险因素,而支架直径、拜阿司匹林及他汀类药物服用率与ISR呈负相关(P0.05)。结论糖化血红蛋白、超敏C反应蛋白、低密度脂蛋白、载脂蛋白b、心肌桥、分叉病变等是ISR的独立危险因素,而大直径支架、阿司匹林及他汀类药物是ISR的保护性因素。
[Abstract]:Objective to analyze the influencing factors of (ISR) in patients with coronary heart disease (CHD) and to provide theoretical guidance for the prevention of ISR. Methods 300 patients undergoing percutaneous transluminal coronary angioplasty from May 2014 to May 2015 were followed up for 6 to 12 months. The clinical data of the two groups were analyzed and the risk factors of ISR were analyzed by multivariate Logistic regression analysis. Results the levels of low density lipoprotein, glycosylated hemoglobin, apolipoprotein b, hypersensitive C-reactive protein, the number of stents implanted, the length of stents, the incidence of myocardial bridge and bifurcation in ISR group were higher than those in no ISR group (P0.05). The diameter of stents in ISR group was significantly smaller than that in non-ISR group (2.58 卤0.52 vs.2.98 卤0.48p0.001). ISR). The usage rate of clopidogrel and statins was higher than that of non-ISR group (P0.05). Multivariate Logostic regression analysis showed that glycosylated hemoglobin, hypersensitive C-reactive protein, low density lipoprotein, apolipoprotein b, myocardial bridge, bifurcation lesion and so on were risk factors of ISR, while stent diameter. Aspirin and statins were negatively correlated with ISR (P0.05). Conclusion glycosylated hemoglobin, hypersensitive C-reactive protein, low density lipoprotein, apolipoprotein b, myocardial bridge and bifurcation lesions are independent risk factors of ISR, while large diameter stents, aspirin and statins are protective factors of ISR.
【作者单位】：上海市普陀区中心医院心内科;
【基金】：上海市医学重点专科心内科资助项目(编号:ZK2015A17)
【分类号】：R541.4

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