摘要
目的探讨经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗后患者血脂控制水平与支架内再狭窄的相关性。方法选择2014年5月至2016年5月于铜川矿务局中心医院行PCI治疗的243例患者的临床资料,在术后3个月至1年复查冠状动脉造影,根据造影结果分为再狭窄组(n=25)和非狭窄组(n=218),定量分析首次入院和复查造影时的血脂浓度,分析患者血脂控制水平与术后支架内再狭窄的关系。结果两组患者在年龄,性别,吸烟史,饮酒史,高血脂史,发病前使用药物,入院血压,基线实验室指标,复查造影时三酰甘油(triacylglycerol,TG)、高密度脂蛋白胆固醇(high-density lipoprotein cholesterol,HDL-C)、空腹血糖(fasting blood glucose,FBG)浓度,复查造影术时TG、HDL-C、总胆固醇(total cholesterol,TC)浓度下降患者比例等比较,差异无统计学意义(P>0.05)。两组患者在高血压史、糖尿病史、卒中史、复查造影时的TC、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)浓度以及随访时LDL-C浓度比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果表明糖尿病史(OR=1.491,95%CI=1.133～2.116,P=0.021)、复查时高LDL-C浓度(OR=1.542,95%CI=1.123～2.457,P=0.011)、LDL-C未达标(OR=2.134,95%CI=1.342～3.482,P=0.0.024)是PCI治疗后支架内再狭窄的独立危险因素。结论血脂控制欠佳尤其是LDL-C浓度控制不佳与PCI治疗后支架内再狭窄的发生密切相关。
Objectives To explore the relationship between lipid control level and in-stent restenosis(ISR)in patients after percutaneous coronary intervention(PCI).Methods Clinical data of243patients after PCI from May2014to May2016in Central Hospital of Tongchuan Mining Bureau were collected.They were divided into ISR group(n=25)and non ISR group(n=218)according to angiography results after3months to1year.Concentrations of lipid were quantitatively analyzed for the first time of admission and reexamination,and the relationship between lipid control and ISR in patients after PCI were analyzed.Results There were no statistically significant difference in age,gender,smoking history,drinking history,history of high concentration of cholesterol,before the onset of drug usage,blood pressure,baseline laboratory indexes,high-density lipoprotein cholesterol(HDL-C),triacylglycerol(TG)after angiography in the two groups(P>0.05).There were statistically significant differences in history of hypertension,history of diabetes,history of stroke,concentrations of total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C)during the reexamination,and concentration of LDL-C in the follow-up examination between the two groups.Multivariate Logistic regression analysis showed that history of diabetes(OR=1.491,95%CI=1.133-2.116,P=0.021),high concentration of LDL-C in reexamination(OR=1.542,95%CI=1.123-2.457,P=0.011)and not-achieving-target concentration of LDL-C control(OR=2.134,95%CI=1.342-3.482,P=0.0.024)were the independent risk factors of ISR in patients after PCI.Conclusions Poor controlling of blood lipids,especially poor controlling of LDL-C,was closely related to ISR in patients after PCI.
作者
张军
马斐
刘超
ZHANG Jun;MA Fei;LIU Chao(Department of Cardiovascular,Central Hospital of Tongchuan Mining Bureau,Tongchuan,Shaanxi 727000,China)
出处
《岭南心血管病杂志》
2018年第6期644-647,共4页
South China Journal of Cardiovascular Diseases
