廖家有 周爱琴 刘心强 凌嘉源

【摘要】 目的：分析并探討冠心病药物支架植入术后支架内再狭窄患者的临床危险因素。方法：选取2018年12月-2020年6月本院收治的150例冠脉支架（药物支架）植入术≥9个月复查造影的冠心病患者为研究对象进行回顾性调查研究，观察术后支架内再狭窄的发生情况并进行统计分析。将患者按照是否发生支架内再狭窄分为再狭窄组（ISR组）40例和未狭窄组（NISR组）110例。结果：150例患者中，PCI术后发生支架内再狭窄的患者40例，发生率为26.7%。两组年龄、性别、左室射血分数、心力衰竭、高血压、脑卒中、高脂血症、尿酸、同型半胱氨酸比较，差异均无统计学意义（P>0.05）;两组吸烟、糖尿病、总胆固醇和低密度脂蛋白胆固醇水平比较，差异均有统计学意义（P<0.05）。多因素logistic回归分析显示，糖尿病、吸烟、总胆固醇、低密度脂蛋白胆固醇均是冠心病患者PCI术后ISR的独立危险因素（P<0.05）。结论：临床工作中应注意患者常见临床危险因素，如糖尿病的控制，通过教育培养良好的生活习惯，戒烟或不吸烟、低脂饮食，积极治疗基础疾病如高脂血症、糖尿病，减少PCI术后ISR的发生，改善患者术后疗效和远期预后。

【关键词】 冠心病 经皮冠状动脉介入术 药物支架 支架内再狭窄 危险因素

Retrospective Study on Risk Factors of Drug-eluting In-stent Restenosis in Patients with Coronary Heart Disease after PCI/LIAO Jiayou， ZHOU Aiqin， LIU Xinqiang， LING Jiayuan. //Medical Innovation of China， 2021， 18（28）： -122

[Abstract] Objective： To analyze and explore the clinical risk factors of drug-eluting in-stent restenosis in patients with coronary heart disease after PCI. Method： From December 2018 to June 2020， 150 patients with coronary heart disease who had undergone coronary stent implantation for more than 9 months and returned to angiography in our hospitial were selected as the research objects. The occurrence of in-stent restenosis was observed and statistically analyzed. The patients were divided into restenosis group （ISR group， n=40） and non stenosis group （NISR group， n=110） according to the occurrence of in-stent restenosis. Result： Among 150 patients， 40 cases had in-stent restenosis after PCI， the incidence was 26.7%. There were no significant differences in age， gender， left ventricular ejection fraction， heart failure， hypertension， stroke and hyperlipidemia， uric acid and homocysteine between two groups （P>0.05）， but there were significant differences in smoking， diabetes， total cholesterol and LDL-C between two groups （P<0.05）. Multivariate logistic regression analysis showed that diabetes， smoking， total cholesterol， LDC-L were independent risk factors of ISR in patients with coronary heart disease after PCI （P<0.05）. Conclusion： We should pay attention to the common clinical risk factors such as diabetes mellitus in clinical practice， cultivate good living habits through education， quit smoking or non-smoking， low-fat diet， actively treat basic diseases such as hyperlipidemia and diabetes to reduce the incidence of in stent restenosis after PCI， and improve the curative effect and prognosis of patients.

[Key words] Coronary heart disease Percutaneous coronary intervention Drug-eluting stent In-stent restenosis Risk factors

First-author’s address： The First Affiliated Hospital of Gannan Medical University， Gannan Branch Center of National Geriatric Disease Clinical Medical Research Center， Ganzhou 341400， China

doi：10.3969/j.issn.1674-4985.2021.28.029

在全球范围内，冠心病已成为威胁全人类生命健康的主要疾病之一。自改革开放以来我国经济快速发展，人民生活水平明显提高，生活方式发生了显著变化，我国心血管系统疾病患病率呈现逐年上升趋势，冠心病下降的拐点仍未出现，冠心病仍是导致我国居民死亡的主要病种之一[1]。……