中国介入心脏病学杂志2024,Vol.32Issue(9) :489-495.DOI:10.3969/j.issn.1004-8812.2024.09.002

复发性药物洗脱支架内再狭窄的危险因素分析

Risk factors analysis of recurrent drug-eluting stent in-stent restenosis

冯欢欢 袁晓航 胡鑫 韩燕 张茜 叶豪奕 高磊
中国介入心脏病学杂志2024,Vol.32Issue(9) :489-495.DOI:10.3969/j.issn.1004-8812.2024.09.002

复发性药物洗脱支架内再狭窄的危险因素分析

Risk factors analysis of recurrent drug-eluting stent in-stent restenosis

冯欢欢 1袁晓航 2胡鑫 3韩燕 2张茜 2叶豪奕 2高磊3
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作者信息

  • 1. 中国人民解放军总医院第一医学中心急诊科,北京 100853;中国人民解放军医学院,北京 100853
  • 2. 中国人民解放军医学院,北京 100853
  • 3. 中国人民解放军总医院第一医学中心心内科,北京 100853
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摘要

目的 评估药物洗脱支架(DES)内复发性支架内再狭窄(R-ISR)发生的预测因素.方法 选择2010年1月至2023年8月在中国人民解放军总医院第一医学中心就诊并接受经皮冠状动脉介入治疗(PCI)的201例支架内再狭窄(ISR)患者作为研究对象,根据出院后造影复查情况将患者分为R-ISR组和非R-ISR组,回顾性分析其首次ISR-PCI时的临床基线资料以及介入手术病变特征.结果 201例患者中男168例,平均年龄(61.97±10.02)岁.中位造影复查间隔时间为1.5年,根据患者造影复查情况将患者分为两组:R-ISR组(98例患者和104处ISR病变)和非R-ISR组(103例患者和111处ISR病变).多因素Logistic回归分析显示,R-ISR的发生与血管开口病变(OR 2.987,95%CI 1.343~6.642,P=0.007)、单纯冠状动脉球囊扩张术(POBA)处理ISR病变(OR 3.081,95%CI 1.293~7.343,P=0.011)以及术前ISR病变最大直径狭窄率(OR 1.016,95%CI 1.002~1.030,P=0.022)独立相关.结论 在目前接受介入治疗的ISR患者中,血管开口病变、POBA处理ISR病变以及ISR病变最大直径狭窄率是R-ISR发生的相关预测因素.

Abstract

Objective To evaluate the predictors of recurrent in-stent restenosis(R-ISR)occurrence in drug-eluting stents(DES).Methods A total of 201 patients with ISR who received percutaneous coronary intervention(PCI)surgery in the First Medical Center of the Chinese PLA General Hospital from January 2010 to August 2023 were selected as the study objects,and the patients were divided into R-ISR group and non-R-ISR group according to their post-discharge angiography review.The clinical baseline data and the features of interventional surgery during the first ISR-PCI were retrospectively analyzed.Results Among the 201 patients,168 were males and 33 were females,with an average age of(61.97±10.02)years.The median interval between initial and follow-up angiography was 1.5 years.Patients were divided into two groups based on their radiographic reviews:R-ISR group(98 patients and 104 ISR lesions)and non-R-ISR group(103 patients and 111 ISR lesions).Multivariate Logistic regression analysis showed that the incidence of R-ISR was correlated with Ostial disease(OR 2.987,95%CI 1.343-6.642,P=0.007),plain old balloon angioplasty(POBA)performed for ISR lesions(OR 3.081,95%CI 1.293-7.343,P=0.011)and the maximum diameter stenosis rate of ISR lesions before surgery(OR 1.016,95%CI 1.002-1.030,P=0.022).Conclusions In patients currently receiving interventional therapy for ISR,Ostial disease,POBA treatment for ISR disease,and maximum diameter stenosis rate of ISR disease were associated predictors of R-ISR development.

关键词

经皮冠状动脉介入治疗/药物洗脱支架/支架内再狭窄/复发性支架内再狭窄

Key words

Percutaneous coronary intervention/Drug-eluting stent/In-stent restenosis/Recurrent in-stent restenosis

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基金项目

北京市自然科学基金面上项目(7242138)

首都卫生发展科研专项项目(首发2024-2-5072)

出版年

2024
中国介入心脏病学杂志
北京大学

中国介入心脏病学杂志

CSTPCDCSCD
影响因子:1.224
ISSN:1004-8812
参考文献量6
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