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目的:回顾性分析非罪犯血管临界病变进展并接受支架介入治疗的危险因素,建立危险因素预测评分,探讨早期鉴别高危非罪犯血管临界病变的临床意义。方法:选取我院234例患者,在冠状动脉(冠脉)罪犯病变介入治疗时发现有非罪犯血管临界病变并在(10.5±7.9)月后随访造影。根据随访期间非罪犯血管临界病变进展是否接受介入治疗,分为介入治疗组(n=86)和非介入治疗组(n=148)。探讨非罪犯血管临界病变进展并接受支架治疗的危险因素预测评分。结果:介入治疗组比非介入治疗组的2型糖尿病的发生率(43.0%vs 29.7%)及吸烟者所占比例(67.4%vs52.0%)均高,差异有统计学意义(P<0.05)。首次冠脉造影(冠造)的结果介入治疗组比非介入治疗组的血管最小内径小,病变长度长;10个月随访冠造结果介入治疗组比非介入治疗组的血管最小内径小、病变长度长、管腔丢失多、狭窄程度进展快。上述比较差异均有统计学意义(P<0.05)。多因素分析显示复杂病变(B2/C)、钙化病变、分叉病变、吸烟及2型糖尿病等危险因素是非罪犯血管临界病变容易进展并接受介入治疗的独立预测因子。危险因素预测评分为3、4和5的患者非罪犯血管临界病变接受支架治疗的比例分别是58.1%、93.3%和100.0%,其中68.3%危险评分≥3的患者非罪犯血管临界病变接受了支架介入治疗。结论:冠脉介入术中发现的非罪犯血管临界病变,危险因素预测评分≥3的高危患者,应接受积极血运重建的治疗策略。
OBJECTIVE: To retrospectively analyze the risk factors of non-culprit vascular disease and to receive stent intervention, establish the predictive score of risk factors, and explore the clinical significance of early identification of high risk non-criminal vascular disease. Methods: A total of 234 patients in our hospital were enrolled in this study. Non-criminally defined critical vessels were found in the interventional treatment of coronary artery (CUI) culprit lesions and were followed up at (10.5 ± 7.9) months. Patients were divided into intervention group (n = 86) and non-intervention group (n = 148) according to whether they were involved in the progression of non-culprit vascular disease at follow-up. To explore the predictive score of the risk factors for the progression of non-culprit vascular disease and receiving stent treatment. Results: The incidence of type 2 diabetes mellitus (43.0% vs 29.7%) and smokers (67.4% vs52.0%) were significantly higher in intervention group than in non-intervention group (P <0.05) ). The results of the first coronary angiography (crown made) results in the intervention group than the non-intervention group, the minimum vascular diameter, length of the lesion; 10 months follow-up results of coronary intervention group than non-intervention group, the minimum vascular diameter, Long length, loss of more lumens, stenosis progressed rapidly. The above differences were statistically significant (P <0.05). Multivariate analysis showed that risk factors such as complicated lesions (B2 / C), calcified lesions, bifurcation lesions, smoking and type 2 diabetes were independent predictors of easy progression of noncubital vascular disease and interventional therapy. The proportion of patients receiving non-criminally defined critical vessel disease who underwent scaffolds with a predictor score of 3, 4, and 5 was 58.1%, 93.3%, and 100.0%, respectively, of whom 68.3% had a risk score of 3 Interventional treatment. CONCLUSIONS: High-risk patients with noncritical vascular lesions and predicted risk factors of ≥3 found during coronary intervention should receive aggressive revascularization strategies.