冠状动脉血管的口径对PTCA术后再狭窄的影响

经皮冠状动脉腔内成形术（PTCA）术后再狭窄仍然是目前的重要难题之一。本研究对303例PTCA成功者，测定正常冠状动脉管径和PTCA术后再狭窄管径，结合临床冠心病危险因子及与再狭窄相关连的病变形态因子的定量分析进行对比研究，采用Automatededgedetecting法测出术前正常冠状动脉管径（NCD）按NCD的大小分为三组，A组NCD＜25mm；B组2．5～3．0mm；C组≥3．0mm；同时分别测出A、B、C三组术前、术后PTCA部位的最小血管径（MVD．mm）以及PTCA术后3个月追踪造影时PTCA部位的MVD，采用Caliper法分别计算出PTCA前、后狭窄率、3个月后追踪时再狭窄率。结果显示，冠心病的危险因子、PTCA前偏心性病变、钙化病变及扩张后冠状动脉夹层在三组间未见显著差异，PTCA前NCD（mm）、MVD（mm）及PTCA术后MVD（mm）C组显著高于A组（P＜0．01），再狭窄率A组显著高于C组（P＜0．01）。我们认为正常冠状动脉径较细者，PTCA术后容易发生再狭窄，冠状动脉本身的粗细可以作为PTCA术后再狭窄的独立预测因子之一。

The influence of normal coronary diameter on restenosis after PTCA

The restenosis after percutaneous transluminal coronary angioplasty (PTCA) is still one of the difficult problems in interventional cardiology. In this paper,we studied the relations among different normal coronary diameters (NCD). Clinical coronary dangerous factors and restenosis after PTCA. The theoretical normal diameters minimum vascular diameters (MVD) at the lesion sites were measured with automated edge datecting methed before PTCA immediate after PTCA and 3 months after PTCA. The ste-nosis rate of lesions were calculated with caliper method. According to NCD at lesion sites .all 303 patients were divided into 3 groups: group A, NCD<2. 5 mm; group B, NCD 2. 5 ~ 3. 0mm; group C, NCD>3.0mm,we found that there were no differences among these 3 group in coronary dangerous factors,eccentric lesions,calcific lesions before PTCA and coronary dissections after PTCA. NCD. MVD before PTCA and MVD after PTCA in group C were larger than those in group A,but the restenosis rate of group A was higher than that of group C significantly (P<0.01). It seems to say that the thiner the NCD is the easier the restensis happens,NCD can be one of the free predictive factors for restenosis after PTCA.