摘要
目的探讨心外膜脂肪组织厚度(EAT)对急性冠脉综合征(ACS)合并2型糖尿病患者经皮冠状动脉支架植入术(PCI)后支架内再狭窄(ISR)的预测价值。方法入选2017年1月至2019年2月于衡水市人民医院心血管内科行药物洗脱支架植入术的急性冠脉综合征患者84例,检测炎症因子超敏C反应蛋白(hs-CRP)的水平,入院24 h内行经胸心脏彩超检查测量EAT。根据术后1年内造影结果是否发生ISR分为ISR组(n=13)和N-ISR组(n=71)。分析EAT及炎症因子与ACS合并2型糖尿病患者PCI术后ISR的关系。结果两组中ISR组血脂异常病史高于N-ISR组、植入支架数目低于N-ISR组、EAT高于N-ISR组[(5.0±0.4)mm vs.(4.5±0.4)mm,P=0.003],两组间差异有统计学意义(P<0.05)。两组患者在性别、年龄、吸烟史、高血压病史以及入院检查低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、hs-CRP、总胆固醇(TC)、三酰甘油(TG)间差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示EAT(OR=9.970,95%CI:1.433~69.362;P=0.020)、支架数目(OR=4.429,95%CI:1.264~15.519;P=0.020)以及支架长度(OR=1.306,95%CI:1.034~1.650;P=0.025)是ISR的危险因素。结论EAT对PCI术后支架内再狭窄有一定预测价值,可以作为临床预测支架内再狭窄的指标。
Objective to investigate the predictive value of epicardial adipose tissue thickness(EAT)on in stent restenosis(ISR)after percutaneous coronary intervention(PCI)in patients with acute coronary syndrome(ACS)and type 2 diabetes mellitus.Methods From January 2017 to February 2019,84 patients with acute coronary syndrome who underwent drug-eluting stent implantation in the Department of cardiovascular medicine of Hengshui people's hospital were selected.The levels of inflammatory factor high-sensitivity C-reactive protein(hs-CRP)were detected,and the eat was measured by transthoracic echocardiography within 24 hours after admission.The patients were divided into ISR group(n=13)and n-isr group(n=71).The relationship between type 2 diabetes mellitus and inflammation after PCI was analyzed.Results In the two groups,the history of dyslipidemia in ISR group was higher than that in n-isr group,the number of stents implanted in ISR group was lower than that in n-isr group,and eat was higher than that in n-isr Group[(5.0±0.4)mm vs.(4.5±0.4)mm,P=0.003].There was no significant difference in gender,age,smoking history,history of hypertension,low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),hs CRP,total cholesterol and triglyceride between the two groups(P>0.05).Multivariate logistic regression analysis showed that eat(OR=9.970,95%CI:1.433~69.362,P=0.020),stent number(OR=4.429,95%CI:1.264~15.519,P=0.020)and stent length(OR=1.306,95%CI:1.034~1.650,P=0.025)were risk factors for ISR.Conclusion Eat has a certain predictive value for in stent restenosis after PCI,and can be used as a clinical index to predict in stent restenosis.
作者
王雅
路玉李
张艳
肖建东
马星
Wang Ya;Lu Yuli;Zhang Yan;Xiao Jiandong;Ma Xing(Department of Cardiology,International Peace Hospital,Hengshui,Hebei 053000,China;不详)
出处
《中国循证心血管医学杂志》
2021年第6期722-725,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
衡水市科学技术研究与发展计划项目(2019014053Z)。
关键词
心外膜脂肪组织厚度
急性冠脉综合征
2型糖尿病
支架内再狭窄
Epicardial adipose tissue thickness
Acute coronary syndrome
Type 2 diabetes mellitus
In stent restenosis
