摘要
目的探讨同型半胱氨酸(homocysteine,HCY)对稳定型心绞痛(stable angina pectoris,SAP)患者支架内再狭窄的影响。方法 168例SAP患者成功行支架置入治疗,根据术后12~18个月冠状动脉造影结果分为再狭窄组(支架内狭窄≥50%,72例)及对照组(支架内狭窄〈50%,96例);测定患者HCY水平,同时对支架置入前、置入后即刻及12~18个月后的冠状动脉造影结果进行计算机辅助的定量分析法(quantitative coronary analysis,QCA)评价。结果对照组HCY水平显著低于再狭窄组[(11.68±3.54)μmol/L比(18.54±4.39)μmol/L,P=0.012]。两组患者术前及术后即刻的最小管腔直径、狭窄程度比较,差异均无统计学意义(均P〉0.05);术后12~18个月对照组狭窄程度显著低于再狭窄组[(33.24±12.52)%比(84.23±13.26)%,P=0.000];对照组的晚期管腔丢失显著小于再狭窄组[(0.36±0.21)mm比(1.82±0.68)mm,P=0.000]。多因素logistic回归分析显示,HCY与术后支架内再狭窄有关,回归系数为-0.578,P=0.023(OR 0.693,95%CI 0.548~0.952)。结论 HCY可能是SAP患者发生支架内再狭窄的原因之一。
Objective Mounting interest emerged about hyper homocystinemia as an independent risk factor for atherothrombotic disease,and several experimental studies have shown that it may affect instent restenosis. The purpose of the present study was to identify the relationship between the serum homocystine level and in-stent restenosis of patients with stable angina after coronary stenting.Methods The study population comprised 168 stable angina patients who underwent stent implantation with drug-eluting stents,including 96 patients without in-stent restenosis( the control group) and 72 patients with in-stent restenosis( the restenosis group). The level of serum homocystine was measured using the medical inspection center. Coronary angiography was performed immediately before and after stent implantation and12- 18 months later. Results Baseline characteristics including drug used after PCI were similar between the2 groups. Serum homocystinelevel in patients of the control group were significantly lower than that in restenosis group [( 11. 68 ± 3. 54) μmol / L vs.( 18. 54 ± 4. 39) μmol / L,P = 0. 012]. The quantitative coronary angiography( QCA) showed that lesion length was similar between the 2 groups,minimumlumen diameter( MLD) and stenosis rate were also similar before and after stents implantation( all P〉 0. 05). Restenosis rate[( 33. 24 ±12. 52) % vs.( 84. 23 ±13. 26) %,P =0. 000]and late lumen less [( 0. 36 ±0. 21) mm vs.( 1. 82± 0. 68) mm,P = 0. 000] were lower in the control group than in the restenosis group. Conclusions Higher serum homocystine level might be associated with in-stent restenosis after coronary stenting.
出处
《中国介入心脏病学杂志》
2016年第3期145-148,共4页
Chinese Journal of Interventional Cardiology