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目的:探讨与支架内再狭窄相关的临床、冠脉病变特征和技术操作因素。 方法 :采用定量冠脉造影分析系统 (QCA)分析和测量北京朝阳医院心脏中心和北大医院心内科 10 7例经 PTCA联合支架干预后病人的临床及冠脉造影资料 ,再狭窄 6 3例 ,无再狭窄 4 4例 ,2 11处病变 ,置入支架 182枚 ,平均随访时间 (2 4 8± 2 3) d。随访时直径狭窄百分数≥ 5 0 %为支架内再狭窄 ,再狭窄是二项分类变量。运用 L ogistic回归分析再狭窄的相关因素。结果 :多因素分析表明 ,糖尿病 (OR值 1.82 ,95 % CI:1.6 0～ 2 .5 8)、长病变 (OR值 1.4 4 ,95 % CI:1.17～ 1.87)、术后最小管腔直径 (ML D) (OR值 0 .16 ,95 % CI:0 .0 3～ 0 .80 )和多个支架 (OR值 2 .34,95 % CI:1.2 0～ 5 .4 4 )是再狭窄的相关因素 (P <0 .0 5 )。糖尿病、长病变和多个支架是再狭窄的危险因子 (P <0 .0 5 ) ,而术后 ML D与再狭窄呈相反的关系 (P <0 .0 5 )。 结论:糖尿病、长病变和多个支架是再狭窄独立的危险因素 ,增加再狭窄的发生 ,而术后ML D减少再狭窄的发生。成功地置入单个支架 ,造影效果满意的病人再狭窄率低。
OBJECTIVE: To investigate the characteristics of clinical and coronary lesions associated with in-stent restenosis and technical operational factors. Methods: Quantitative coronary angiography (QCA) was used to analyze and measure the clinical and coronary angiographic data of 107 patients who were treated with PTCA combined with coronary stents in the Department of Cardiology, Beijing Chaoyang Hospital and Peking University Hospital. Sixty-three cases of restenosis Restenosis was performed in 44 cases and 2-11 lesions. A total of 182 stents were inserted, with a mean follow-up time of (24.8 ± 23) days. At follow-up, the percentage of diameter stenosis ≥ 50% was intra-stent restenosis, and restenosis was a dichotomous variable. Using ogistic regression to analyze the related factors of restenosis. Results: Multivariate analysis showed that patients with long-term disease (OR 1.4 4, 95% CI: 1.17-1.87), diabetic patients (OR 1.82, 95% CI 1.6 0-2.58) ML D) (odds ratio 0.16, 95% CI: 0.030 to 0.80) and multiple stents (odds ratio, 2.34, 95% CI: 1.2 0 to 5.44) Related factors (P <0.05). Diabetes mellitus, long lesions and multiple scaffolds were risk factors for restenosis (P <0.05), while postoperative postoperative MLD was inversely related to restenosis (P <0.05). CONCLUSION: Diabetes mellitus, long lesions and multiple scaffolds are independent risk factors for restenosis, increasing the incidence of restenosis, while postoperative ML D reduces the incidence of restenosis. Successfully placed in a single stent, angiography satisfactory patient restenosis rate is low.