冠脉支架术后患者支架内再狭窄原因的回顾性研究

目的 通过对冠脉支架植入术后复查冠脉造影患者的回顾性分析,研究引起支架内再狭窄(ISR)的可能原因.方法 入选2009年～2010年所有复查造影的冠心病支架治疗患者73例,将其分成支架内再狭窄组及无再狭窄组,分析两组间可能导致支架内再狭窄的因素间差异.结果 73例患者共植入177枚支架,其中有22枚支架发生再狭窄(支架内再狭窄定义为随访时造影提示支架内管腔内径损失≥50%).分析两组基本临床资料特征及支架长度、直径,是否为药物涂层支架等因素;支架内再狭窄组及无再狭窄组在吸烟、2型糖尿病、支架长度、直径和药物/非药物支架方面有显著差异(P ＜0.05).Cox比例风险回归模型显示仅支架长度(P=0.009)、直径(P=0.029)和药物/非药物支架(P=0.026)为冠心病介入患者发生ISR的预测因子.结论 冠脉支架植入后发生再狭窄的主要原因为支架长度、直径及是否为药物支架.

Study on Reasons of In-stent Restenosis in Patients with PCI

Objective To recheck CAG（coronary angiography） to analysis the possible reasons of in-stent restenosis（ISR） through following-up patients who accepted PCI（percutaneous coronary intervention） therapy. Method 73 cases which were CHD（coronary heart disease） patients who underwent CAG after PCI therapy between 2009 and 2010 were enrolled.All these cases are divided into two groups according to CAG which were restenosis group and non-restenosis group.Then we compared the possible reasons for restenosis between the two groups.Result 177 stents were implanted in 73 patients.22 stents in 15 patients had restenosis.We found that there were significant difference between restenosis group and non-restenosis group in smoking,diabetes mellitus,the length and diameter of stent and whether the stent is drug-eluted or not（P 〈 0.05）.Cox proportional hazards regression model showed that the length（P=0.009） and diameter of stent（P=0.029） and whether the stent is drug-eluted or not（P=0.026） are independent prognosis factors of restenosis in stent.Conclusion The primary reasons of in-stent restenosis are the length and diameter of stent and whether the stent is drug-eluted or not.