目的：探讨冠心病患者冠状动脉支架植入术后支架内再狭窄（ ISR）的影响因素。方法选取冠心病行经皮冠状动脉介入治疗（ PCI）患者120例，均于6～12个月内行冠状动脉造影（ CAG）复查，根据是否发生ISR分为ISR组32例和无ISR组88例，观察两组一般资料、靶血管病变和支架特征、支架置入前左室射血分数及临床血清学指标，分析ISR发生的相关影响因素。结果 ISR组有吸烟史、糖尿病患者比例及纤维蛋白原（FIB）水平高于无ISR组（P＜0.05或P＜0.01）；冠状动脉Gensini积分、术前狭窄程度、支架长度大于无ISR组（P＜0.05或P＜0.01），支架直径小于无ISR组（P＜0.05）；Logis-tic回归分析显示，吸烟、糖尿病、冠状动脉Gensini积分和术前狭窄程度及支架长度较大是ISR发生的危险因素，支架直径较大是ISR发生的保护因素。结论吸烟、糖尿病、冠状动脉Gensini积分和术前狭窄程度、支架长度和直径与ISR的发生相关。%Objectives To explore the influencing factors of postoperative in-stent restenosis ( ISR) after coronary stent implan-tation in patients with coronary heart disease ( CHD).Methods A total of 120 CHD patients undergoing percutaneous coronary in-tervention ( PCI) were selected and given reexamination with coronary angiography ( CAG) within 6~12 months.All patients were divided into ISR group (32 cases) and non-ISR group (88 cases) according to the presence of ISR.The clinical data, the charac-teristics of target vascular lesion and intents, left ventricular ejection fraction ( LVEF) before intent implantation and clinical serum indexes of both groups were observed, and ISR-associated relevant influencing factors were analyzed.Results ISR group was evi-dently higher in the ratio of patients with smoking history and diabetes and the fibrinogen ( FIB) level ( P<0.05 or P<0.01) , ob-viously larger in coronary artery Gensini score, preoperative stenosis severity and intent length (P<0.05 or P<0.01), but marked-ly less in intent diameter than non-ISR group (P<0.05).Logistic regression analysis showed that smoking, diabetes, coronary ar-tery Gensini score and larger preoperative stenosis severity and intent length were the risk factors while longer intent diameter the protective factor for the development of ISR.Conclusions Smoking, diabetes, coronary artery Gensini score, preoperative stenosis severity and intent length and diameter are in close association with the development of ISR.
展开▼
