冠心病患者冠脉支架术后发生再狭窄的危险因素回归分析

目的:探讨冠心病患者冠脉支架手术后发生再狭窄的危险因素,为提高临床治疗效果和改善预后提供指导。方法:回顾性分析2014年1月至2015年12月我院收治的226例行冠脉支架手术的冠心病患者临床病历资料,采用SPSS21.0分析冠脉再狭窄的发生情况及危险因素。结果:51例冠心病患者冠脉支架术后发生冠脉再狭窄(22.57%)。单因素分析显示,不同吸烟史、糖尿病史、脂蛋白a(Lp(a))水平、空腹血糖、尿素氮(BUN)、总胆红素、术前病变狭窄程度、植入支架支数、长度以及直径组冠心病患者的冠脉再狭窄发生率比较,差异有统计学意义(P0.05)。多因素Logistic回归分析,吸烟史、糖尿病史、Lp(a)水平、术前病变狭窄程度、植入支架支数、长度是冠心病患者冠脉支架术后再狭窄发生的独立危险因素,OR分别为2.261、1.944、3.593、2.798、2.449、3.823,差异有统计学意义(P0.05),植入支架直径是冠脉再狭窄发生的保护因素,OR为0.261,差异有统计学意义(P0.05)。结论:冠脉植入支架的总长度、数量,术前病变的狭窄程度、Lp(a)水平、糖尿病以及吸烟是冠心病患者冠脉支架术后发生再狭窄的独立危险因素,临床应不断优化支架并根据再狭窄的危险因素采取针对性的防治措施。

Regression Analysis of Risk Factors of Restenosis in Patients with Coronary Heart Disease after Coronary Stenting Surgery

Objective:To explore the risk factors of restenosis in patients with coronary heart disease after coronary stenting surgery, so as to provide guidance for promoting clinical efficacy and improving prognosis.Methods:The clinical data of 226 patients with coronary hart disease trested by coronary stenting surgery in our hospital from January 2014 to December 2015 were retrospectively analyzed. The incidence status and risk factors of restenosis were analyzed by the SPSS 21.0.Results:51 patients occurred restenosis after coronary stenosis surgery (22.57%). Univariate analysis showed that the incidence rate of different groups of smoking history, diabetes mellitus history, lipoprotein (Lp (a)), fasting blood glucose, blood urea nitrogen (BUN), total bilirubin, degree of lesion stenosis before surgery, the number of implant frame, implant frame length, and implant frame diameter were statistically significant(P<0.05). Multivariate Logistic regression analysis showed, smoking history, diabetes mellitus history, Lp (a), degree of lesion stenosis before surgery, the number of implant frame, implant frame length were the independent risk factors of restenosis in patients with coronary heart disease after coronary stenting surgery (OR=2.261, 1.944, 3.593, 2.798, 2.449 and 3.823, respectively, P<0.05), the implant frame diameter was the protective factor (OR=0.261, P<0.05).Conclusion:The length and number of implant frame, degree of lesion stenosis before surgery, Lp (a) level, smoking history and diabetes mellitus history are the independent risk factors of restenosis in patients with coronary heart disease after coronary stenting surgery, and it should continuously optimize the stent and take some preventive measures.