| 张凤云,王向东,段 洋,张柏祥,王志荣.支架术后再发急性冠脉综合征患者冠脉病变程度的影响因素分析[J].,2019,19(18):3482-3485 |
| 支架术后再发急性冠脉综合征患者冠脉病变程度的影响因素分析 |
| Analysis of the Influencing Factors of the Severity of Coronary Artery Lesions in the Patients with ACS Onset after Previous PCI Treatment |
| 投稿时间：2018-12-28 修订日期：2019-01-23 |
| DOI：10.13241/j.cnki.pmb.2019.18.017 |
| 中文关键词: 急性冠脉综合征 支架治疗 危险因素 冠脉病变程度 |
| 英文关键词: Acute coronary symptom Percutaneous coronary intervention Risk factor Conorany stenosis degree |
| 基金项目:国家自然科学基金青年科学基金项目（81700231) |
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| 中文摘要: |
| 摘要 目的：探讨既往支架术后再次发生急性冠脉综合征患者冠状动脉病变严重程度与冠心病危险因素的相关性。方法：收集本院2017年7月至2018年7月收治的支架术后再次因急性冠脉综合征住院的107例患者，根据冠脉造影结果进行Gensini评分，按照评分高低将冠脉病变严重程度分为轻度(0-6分)、中度(7-14分)、重度组(＞14分)，对冠心病危险因素进行研究，并探讨支架术后再次发生急性冠脉综合征患者冠状动脉病变严重程度与冠心病危险因素之间的相关性。结果：冠脉病变重度组2型糖尿病、吸烟、血脂(TC、TG、LDL-C、ApoB)、肌酐水平升高患者比例较轻度组明显升高(P＜0.05)，血脂(TC、LDL-C、ApoB)、肌酐水平升高患者比例显著高于中度组(P＜0.05)。多元非条件Logistic回归分析显示：吸烟、肌酐水平与冠脉病变程度相关(P=0.033/P＜0.01)，OR(95%CI)分别为4.553(0.087-2.046)，15.991(0.042-0.123)。冠脉病变程度与年龄、高血压、性别、人类SLCO1B1和ApoE基因检测(他汀)检测结果、既往支架至本次发病时间无关。结论：2型糖尿病、吸烟、血脂、肌酐水平与既往支架术后患者再次发生急性冠脉综合征患者的冠脉病变严重程度有关，其中吸烟、肌酐水平是支架术后再次发生急性冠脉综合征患者冠状动脉病变严重程度的独立风险因素。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the clinical characteristics of coronary heart disease risk factors, and explore the relationship of severity of coronary artery lesions in the patients with acute coronary symptom (ACS) onset after previous percutaneous coronary intervention (PCI) treatment and coronary heart disease risk factors. Methods: 107 patients with ACS onset after previous PCI treatment in our hospital during July 2017 to July 2018 were prospectively evaluated. The patients undergoing CAG were graded with Gensini method, and assigned to: group A, the total score 0-6; and group B, the total score 7-14; and group C, the total score＞14. The clinical data of 3 groups were used to analyse the relationship between severity of coronary artery pathological changes and coronary heart disease risk factors. Results: Compared with the mild coronary stenosis group，the percentage of smoking, type 2 diabetes, lipid level (TC, TG, LDL-C, ApoB) and Scr level increased patients were obviously higher in the severe group (P<0.05), the percentage of patients with smoking and type 2 diabetes, the lipid level (TC, LDL-C, ApoB) and Scr level were significantly higher in the severe group than those of the moderate group (P<0.05). Multivariate logistic regression shown that smoking, Scr had close relationship with conorany stenosis degree in the above patients (P=0.033/P<0.01), OR (95% CI) were 4.553(0.087-2.046) and 15.991(0.042-0.123), respectively. The results found there was no relationship among age, sex, hypertension, human SLCO1B and ApoE gene test result and the time between previous PCI treatment and second ACS onset. Conclusion: Type 2 diabetes, smoking, lipid level (TC, TG, LDL-C, ApoB) and Scr level had close relationship with the severity of coronary artery in the patients of ACS onset after previous PCI treatment, smoking and Scr were identified as the independent predictors of the severity of coronary artery lesions. |
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