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冠状动脉旁路移植术后早期移植物通畅性的影响因素分析

Influencing Factors of Early Graft Patency After Coronary Artery Bypass Grafting
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摘要 目的分析影响冠状动脉旁路移植术(CABG)后早期移植物通畅性的因素,为CABG围手术期诊断及预防桥血管病变提供依据及参考。方法回顾性分析2005年1月1日至2020年12月1日于郑州大学第一附属医院接受CABG治疗的348例患者的临床资料,根据术后1个月桥血管病变情况将患者分为病变组(64例)和通畅组(284例)。采用多因素logistic回归分析寻找桥血管通畅率的影响因素,应用χ^(2)检验分析桥血管来源与术后早期病变的关系。结果多因素logistic回归分析结果显示:吸烟、糖尿病、高脂血症、心肌梗死病史、冠状动脉内膜剥脱术是CABG术后桥血管早期病变的独立危险因素(P<0.05),体质量指数(BMI)≥28 kg·m^(-2)为其保护因素(P<0.05)。病变组静脉桥占比高于通畅组(P=0.037)。结论吸烟、糖尿病、高脂血症、心肌梗死病史、术中同期行内膜剥脱术是CABG术后早期桥血管通畅性的危险因素,BMI≥28 kg·m^(-2)为桥血管病变的保护因素。动脉桥术后早期通畅性较静脉桥好。 Objective To analyze the factors that affect the early graft patency after coronary artery bypass grafting(CABG),and provide evidence and reference for the diagnosis and prevention of graft disease during the perioperative period of CABG.Methods The clinical data of 348 patients who received CABG in the First Affiliated Hospital of Zhengzhou University from January 1,2005 to December 1,2020 were retrospectively analyzed.The patients were divided into diseased group(64 cases)and patency group(284 cases)according to the condition of bridging vessel disease 1 month after the operation.Multivariate logistic regression analysis was used to find the influencing factors of graft patency.The chi-square test was used to analyze the relationship between the source of grafts and early postoperative lesions.Results Multivariate logistic regression analysis showed that smoking,diabetes,hyperlipidemia,myocardial infarction,and coronary endarterectomy were independent risk factors for early pathological changes of grafts after CABG(P<0.05),and body mass index(BMI)≥28 kg·m^(-2) was its protective factor(P<0.05).The proportion of venous bridges in diseased group was higher than that in patency group(P=0.037).Conclusions Smoking,diabetes,hyperlipidemia,myocardial infarction,and intraoperative endometrial ablation are risk factors for the patency of bridging vessels early after CABG,and BMI≥28 kg·m^(-2) is a protective factor for bridging vessel disease.Arterial bridge has better patency in the early stage after CABG than venous bridge.
作者 陈郑 赵国昌 赵文增 刘超 CHEN Zheng;ZHAO Guochang;ZHAO Wenzeng;LIU Chao(Cardiovascular Surgery WardⅠ,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处 《河南医学研究》 CAS 2021年第17期3085-3089,共5页 Henan Medical Research
关键词 冠心病 冠状动脉旁路移植术 移植物通畅性 影响因素 coronary heart disease coronary artery bypass grafting graft patency influencing factor
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