冠状动脉内支架再狭窄的多因素回归分析.docVIP

冠状动脉内支架再狭窄的多因素回归分析 2010-12-15 郭静萱　毛节明　郭丽君　张福春　李海燕　温尚煜　赵一鸣　陈明哲 　　【摘要】　目的　分析与冠状动脉内支架再狭窄有关的临床和血管造影及其处理因素。方法　回顾性分析了在我院成功冠状动脉内支架置入和6个月后有冠状动脉造影随访的74例病人的临床和血管造影及处理资料。用单因素和多因素回归分析方法分析了病人年龄、冠心病易患因素、靶病变形态学、及术后最小管腔开放直径（MLD）等32个变量与再狭窄的关系。结果　在单因素分析中发现：术前血管参照直径和术后MLD在再狭窄组明显低于非再狭窄组(3.1±0.3 mm vs 3.3±0.4 mm和2.9±0.4 vs 3.2±0.4 mm(P0.05和0.01)。支架直径小于3.5 mm组的再狭窄率明显高于支架直径大于3.5 mm组的再狭窄率(41.7% vs 10.8%, P0.05)。多元Logistic回归分析发现: 术后支架管腔MLD、支架直径3.5 mm、吸烟和高龄是再狭窄的独立危险因素。结论　术后支架管腔MLD、支架直径3.5 mm、吸烟和高龄是最重要的支架再狭窄的独立危险因素。 　　【关键词】　冠状动脉疾病　　支架　　再狭窄 Multivariate analysis of post-stenting coronary restenosis Guo Jingxuan, Mao Jieming, Guo Lijun, et al. Third Teaching Hospital Cardiology Division, Beijing Medical University , Beijing 100083 　　【Abstract】　Objective　To study the relationship between post -stenting coronary restenosis and its relevant clinical, angiographic and procedural factors.Methods　The data of 74 patients who successfully underwent coronary stent implantation and six-month angiographic follow-up were analyzed retrospectively. We used univariate and multivariate analysis to study the relationship between restenosis and 32 other factors including patient′s age,risk factors for coronary heart disease , morphologic characteristics of target lesions and postprocedural minimal luminal diameter (MLD), etc. Results　Univariate analysis revealed that the reference-vessel diameter and post-stenting MLD in the restenosis group were significantly smaller than in the non-restenosis group (3.05±0.31 mm vs 3.26±0.39 mm, P0.05 and 2.94?.36 mm vs 3.22?.37 mm P0.01, respectively). The restenosis rate was higher in the subset of patients with stent diameter 3.5 mm compared to those with stent diameter 3.5 mm (47.7% vs 10.8%, P0.05). Multivariate analysis revealed that post-stenting MLD,stent diameter 3.5 mm, smoking and age were the independent risk factors for coronary post-stenting restenosis. Conclusion　postprocedural MLD, smoking, stent diameter 3.5 mm and old age are the most important indep