经皮冠状动脉介入术中并发冠脉穿孔的危险因素

 目的 探讨经皮冠状动脉介入术并发冠脉穿孔的危险因素。方法 选择2011-01至2020-09在解放军总医院心血管内科住院行经皮冠状动脉介入术患者,根据是否并发冠脉穿孔进行分组,采用多因素Logistic回归分析经皮冠状动脉介入术并发冠脉穿孔的危险因素。结果 共有57 580例行冠脉介入治疗的患者,其中90例术中出现冠脉穿孔作为病例组,同时采用单纯随机抽取的方法,在同期住院的其余行冠脉介入治疗的患者中抽取180例作为对照组。多因素Logistic回归分析显示,年龄＞70岁(OR=2.69,95% CI:2.25~3.13)、女性(OR=1.46, 95% CI:1.05~1.87)、糖尿病病史(OR=3.05,95% CI:2.11~3.99)、C型病变(OR=3.69, 95% CI:3.02~4.36)、完全闭塞病变(OR=4.52,95% CI:3.88~5.16)、靶血管钙化(OR=1.52, 95% CI:1.17~1.87)、亲水性导丝(OR=2.58, 95% CI:2.11~3.05)、旋磨治疗(OR=10.4, 95% CI:8.87~11.93),为并发冠脉穿孔的独立危险因素。结论 年龄＞70岁、女性、糖尿病病史、C型病变、完全闭塞病变、钙化病变、亲水性导丝、旋磨术是冠脉介入治疗并发冠脉穿孔的独立危险因素。

Risk factors for coronary artery perforation during percutaneous coronary intervention

Objective To analyze the risk factors for coronary artery perforation during percutaneous coronary intervention. Methods The clinical data on patients treated with percutaneous coronary intervention in the Department of Cardiology of Chinese PLA General Hospital between January 2011 and September 2020 was consecutively collected. These patients were grouped according to the occurrence of coronary perforation. Multivariate logistic regression analysis was used to analyze risk factors for complications with coronary perforation during percutaneous coronary intervention. Results A total 57 580 patients were enrolled in the final statistical analysis, 90 cases of whom were complicated with coronary perforation. Multivariate logistic regression analysis showed that age above 70(OR=2.69, 95% CI:2.25-3.13), femininity(OR=1.46, 95% CI:1.05-1.87), diabetic history(OR=3.05, 95% CI:2.11-3.99), type C lesions(OR=3.69, 95% CI:3.02-4.36), complete occlusion lesions(OR=4.52,95% CI:3.88-5.16), calcification(OR=1.52, 95% CI:1.17-1.87), hydrophilic guide wire and rotablation (OR=10.4, 95% CI:8.87-11.93) were correlated with the incidence of coronary perforation. Conclusions Age above 70, femininity, a history of diabetes mellitus, type C lesions, complete occlusion lesions, calcification, hydrophilic guide wire and rotablation are independent risk factors for the incidence of coronary perforation in patients under percutaneous coronary intervention.