药物洗脱支架治疗后冠状动脉再狭窄相关因素的分析

目的探讨药物洗脱支架治疗后冠状动脉再狭窄与临床和造影的相关因素。方法入选416例冠状动脉造影(CAG)资料完整的冠心病患者,男性328例,女性88例,共置入支架470枚,按照CAG结果分为再狭窄组59例和无再狭窄组357例,平均造影随访时间(7．91±2．37)个月。结果再狭窄组CAG示61枚支架发生再狭窄(13．0％),女性、既往冠状动脉旁路移植术(CABG)病史、慢性闭塞(CTO)病变病史、最大球囊释放压力、置入支架长度与术后再狭窄相关(P<0．05);置入支架血管直径与再狭窄高度相关(OR=0．61,95％CI:0．43～0．82,P< 0．01)。结论女性、既往CABG病史、CTO病变、血管直径、置入支架长度是支架术后再狭窄的危险因素,而糖尿病史等与再狭窄无关。

Predictive factors of in-stent restenosis after coronary implantation of drug-eluting stent

Objective To explore clinical and angiographic in-stent restenosis (ISR) predictive factors after sirolimus-eluting stent(SES) implantation. Methods All 416 patients including 88 females, who underwent successful implantation of 470 SES,were eligible for this study. The patients were angiographically divided into restenosis group (59patients) and non-restenosis group (357patients) during the mean (7.91±2.37) months of follow-up. Results Sixty-one stents(13%) angiographically showed restenosis. Female sex,coronary artery bypass graft (CABG) history, complicated coronary lesion, chronic total occlusion (CTO) lesion, vessel size, stent length and maximal balloon pressure were the risk factors of restenosis(P<0.05).Vessel size was the strongest predictive factor of restenosis(OR=0.61,95%CI:0.43-0.82,P<0.001). Conclusion Female, CABG history,CTO lesion,vessel size and length of stent are associated with follow-up restenosis,while traditional risk factors such as diabetes mellitus have no impact on ISR.