心血管康复医学杂志2024,Vol.33Issue(3) :322-326.DOI:10.3969/j.issn.1008-0074.2024.03.14

药物涂层球囊治疗冠状动脉原位病变后靶血管正性重构的多因素分析

Multifactor analysis of positive remodeling of target vessels in orthotopic coronary artery lesions after drug coated balloon therapy

张帆 贾永平
心血管康复医学杂志2024,Vol.33Issue(3) :322-326.DOI:10.3969/j.issn.1008-0074.2024.03.14

药物涂层球囊治疗冠状动脉原位病变后靶血管正性重构的多因素分析

Multifactor analysis of positive remodeling of target vessels in orthotopic coronary artery lesions after drug coated balloon therapy

张帆 1贾永平1
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作者信息

  • 1. 山西医科大学第一医院心血管内科,山西太原 030001
  • 折叠

摘要

目的:探究影响药物涂层球囊(DCB)治疗冠状动脉原位病变后靶血管正性重构的因素.方法:回顾性分析2019年6月-2021年6月于我院行DCB治疗冠状动脉原位病变并出院后行血管内超声(IVUS)或光学相干断层成像(OCT)复查冠状动脉靶血管情况的130例患者的临床资料.根据冠状动脉靶血管情况,患者被分为正性重构组(57例)和负性重构组(73例),采用多因素Logistic回归分析影响冠状动脉原位病变患者DCB治疗后靶血管正性重构的因素.结果:与负性重构组比较,正性重构组男性(74.0%比89.5%)、使用棘突球囊(31.5%比49.1%)、右冠或后降支左室后支病变(11.0%比28.1%)、年收入>10万元(19.2%比35.1%)、运动频数≥5次/周(6.8%比64.9%)比例、随访期间最小管腔直径[(2.22±0.87)mm比(2.95±0.34)mm]、住院费用[70218.42(51461.18,96114.17)元比 91003.74(61930.16,116948.25)元]显著升高,吸烟史(67.1%比38.6%)和睡眠质量差(86.3%比22.8%)比例显著降低,P<0.05或<0.01.多因素Logistic回归分析显示运动频次≥3次/周、睡眠质量好和棘突/切割球囊的使用是此类患者DCB治疗后靶血管正性重构的独立保护因素(OR=0.014~0.097,P均<0.01),而吸烟史是其独立危险因素(OR=3.970,P=0.047).结论:吸烟史是药物涂层球囊治疗冠状动脉原位病变后靶血管正性重构的独立危险因素,而运动频次≥3次/周、睡眠质量好和棘突/切割球囊的使用是其独立保护因素.

Abstract

Objective:To explore the factors affecting the positive remodeling of target vessels in orthotopic coronary artery lesions after drug coated balloon(DCB)treatment.Methods:A retrospective analysis was performed on clin-ical data of 130 patients who received DCB treatment for orthotopic coronary artery lesions in our hospital from June 2019 to June 2021 and underwent intravascular ultrasound(IVUS)or optical coherence tomography(OCT)to review the coronary target vessels after discharge.According to coronary target vessel condition,the patients were divided into positive remodeling group(n=57)and negative remodeling group(n=73).Multivariate Logistic re-gression was used to analyze the factors affecting positive remodeling of target vessels in patients with orthotopic coronary artery lesions after DCB treatment.Results:Compared with negative remodeling group,there were sig-nificant rise in percentages of male(74.0%vs.89.5%),usage of scoring balloon(31.5%vs.49.1%),right coro-nary or posterior descending left ventricular posterior branch lesions(11.0%vs.28.1%),annual income>100000 RMB(19.2%vs.35.1%),exercise frequency ≥5 times/week(6.8%vs.64.9%),minimum lumen diameter dur-ing follow-up[(2.22±0.87)mm vs.(2.95±0.34)mm]and in-hospital fee[70218.42(51461.18,96114.17)RMB vs.91003.74(61930.16,116948.25)RMB],and significant reductions in percentages of smoking history(67.1%vs.38.6%)and poor sleep quality(86.3%vs.22.8%)in positive remodeling group,P<0.05 or<0.01.Multivariate Logistic regression analysis indicated that exercise frequency ≥3 times/week,good sleep quality and usage of scoring/cutting balloon were independent protective factors for positive remodeling of target vessels af-ter DCB treatment in these patients(OR=0.014~0.097,P<0.01 all),while smoking history was its independent risk factor(OR=3.970,P=0.047).Conclusion:Smoking history is an independent risk factor for positive remode-ling of target vessels in orthotopic coronary artery lesions after DCB treatment,while exercise frequency≥3 times/week,good sleep quality and usage of scoring/cutting balloon are its independent protective factors.

关键词

冠状动脉疾病/药物涂层球囊/靶血管重构/影响因素

Key words

Coronary artery disease/Drug-coated balloon/Target vessel remodeling/Influencing factors

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出版年

2024
心血管康复医学杂志
福建省康复医学会 中国康复医学会

心血管康复医学杂志

CSTPCD
影响因子:1.157
ISSN:1008-0074
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