经皮冠状动脉腔内成形术后再狭窄与介入前病变形态学的关系

目的：探讨国人冠心病经皮冠状动脉腔内成形术（ＰＴＣＡ）后再狭窄与冠状动脉（冠脉）病变类型、部位和病变血管数的关系。　　方法：冠心病介入治疗３５２ 例，选择其中６５ 例（８６个病变）术后３～１６个月造影随访者，按随访结果分为再狭窄组（ｎ＝ ３８），非再狭窄组（ｎ＝ ２７），分析再狭窄与病变形态学的关系。　　结果：再狭窄与多个易患因子、多支病变、病变类型和前降支病变呈正相关，与支架置入呈负相关。再狭窄组Ｃ型、钙化病变多见，前降支病变内径丢失比回旋支、右冠脉病变大（Ｐ＜ ０．０５），半年内一支血管病变再狭窄率（１０．２７％ ）低于二支（４１．１０％ ）和三支（４８．５０％ ）血管病变再狭窄率（Ｐ＜ ０．０００１）。　　结论：再狭窄与冠脉病变类型、部位和血管支数相关，Ｃ型及钙化、多支和前降支病变再狭窄率高

Coronary Morphologic Determinants and Restenosis after Percutaneous Transluminal Coronary Angioplasty and Stenting

Objective:To investigate whether angiographic characteristics,lesions on left anterior descending artery(LAD),multivessel coronary disease were higher risks for restenosis. Methods:Angiographic characteristics of lesions were determined in the 65 patients (86 lesions) with the angiographies of pre intervention,post intervention and follow up in all 352 patients with coronary angioplasty or coronary stenting. Results:Restenosis was correlated positively with multivessel disease,lesion types and LAD at follow up,negatively with stent implantation.Late loss percentage of luminal diameter of lesions of LAD was more than that of left circumflex artery and right coronary artery.The rate of restenosis of 86 lesions during 6 months follow up period in patients with one vessel disease,two vessel disease and three vessel disease was 10 27%,41 10% and 48 50% respectively( p <0 0001). Conclusions:Restenosis after coronary angioplasty might correlate significantly with lesion types,stent implantation,and procedure on LAD and multivessel coronary disease.