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目的探讨冠心病介入手术治疗后复发的危险因素。方法选取南丰县人民医院2014年1月—2015年4月收治的冠心病患者218例,患者均采用冠状动脉介入手术治疗,随访1年后行冠状动脉造影,根据结果将其分为复发组(n=41)和未复发组(n=177),回顾性分析两组患者性别、年龄、是否吸烟、是否饮酒、高血压、糖尿病、高脂血症、心肌梗死史、既往冠状动脉介入治疗史、左心室射血分数(LVEF)、本次冠状动脉介入治疗原因、血管狭窄支数、冠状动脉介入治疗的类型、血管狭窄部位、支架相关因素(包括支架数量、支架直径)及血生化检验指标,包括低高密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、肌酐(Cr)、尿素氮(BUN)、总胆固醇(TG)、三酰甘油(TC)、脂蛋白[Lp(a)]、总胆红素(TBi L)、纤维蛋白原(FIB)、尿酸(UA),采用多因素logistic分析冠心病介入术治疗后复发的影响因素。结果 218例患者中术后随访1年行冠状动脉造影检查发现,复发组41例,占18.8%(41/218)。两组患者性别、年龄、是否饮酒、高脂血症、心肌梗死史、既往冠状动脉介入治疗、LVEF、本次冠状动脉介入治疗原因、血管狭窄支数、冠状动脉介入的类型、血管狭窄部位及支架数量比较,差异无统计学意义(P>0.05);复发组患者吸烟率、高血压发病率、糖尿病发病率高于未复发组,支架直径小于未复发组(P<0.05)。两组患者TG、TC、LDL-C、HDL-C、ALT、AST、Cr、BUN水平比较,差异无统计学意义(P>0.05);复发组患者Lp(a)、FIB、UA水平高于未复发组,TBi L低于未复发组(P<0.05)。多因素logistic分析结果显示,吸烟、糖尿病、LP(a)、FIB及UA是冠心病介入手术治疗后复发的独立危险因素,支架直径较大及TBi L较高是冠心病介入手术治疗后复发的独立保护因素(P<0.05)。结论吸烟、糖尿病、LP(a)、FIB及UA是冠心病介入手术治疗后复发的独立危险因素,支架直径较大及TBi L较高是冠心病介入手术治疗后复发的独立保护因素。
Objective To investigate the risk factors of recurrence after coronary intervention in coronary heart disease. Methods 218 patients with coronary heart disease admitted to Nanfeng County People’s Hospital from January 2014 to April 2015 were enrolled in this study. All patients were treated with coronary artery interventional therapy. Coronary angiography was performed one year after follow-up. According to the results, they were divided into recurrence group (n = 41) and no relapse group (n = 177). Retrospective analysis of gender, age, smoking, alcohol consumption, hypertension, diabetes mellitus, hyperlipidemia, history of myocardial infarction, previous coronary intervention , Left ventricular ejection fraction (LVEF), causes of coronary intervention, the number of stenosis, type of coronary intervention, location of stenosis, stent-related factors (including the number of scaffolds, stent diameter) and blood biochemical markers Including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatinine (Cr) BUN, TG, TC, Lp (a), TBi L, Fib, UA, Multivariate logistic analysis of coronary heart disease intervention after the recurrence of the influencing factors. Results 218 patients were followed up for 1 year after coronary angiography examination found that 41 cases of recurrence group, accounting for 18.8% (41/218). Two groups of patients gender, age, whether drinking, hyperlipidemia, history of myocardial infarction, previous coronary intervention, LVEF, the reasons for this coronary intervention, the number of vascular stenosis, type of coronary artery stenosis, vascular stenosis and There was no significant difference in the number of stent between the two groups (P> 0.05). The smoking rate, the incidence of hypertension and the incidence of diabetes in the recurrence group were significantly higher than those in the non-recurrence group (P <0.05). The levels of TG, TC, LDL-C, HDL-C, ALT, AST, Cr and BUN in the two groups were not significantly different (P> 0.05) No recurrence group, TBi L was lower than the non-recurrence group (P <0.05). Multivariate logistic analysis showed that smoking, diabetes mellitus, LP (a), FIB and UA were independent risk factors for recurrence after coronary intervention. The larger stent diameter and higher TBiL were recurrence after coronary intervention Independent protective factors (P <0.05). Conclusion Smoking, diabetes mellitus, LP (a), FIB and UA are independent risk factors for recurrence after coronary intervention. The larger stent diameter and higher TBiL are independent protective factors for the relapse after coronary intervention.