冠状动脉支架置入后再狭窄危险因素的Logistic回归分析
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The Risk Factors for Restenosis in Patients Treatment of Coronary Stenting : a Logistic Regression Analysis
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    目的 探讨冠状动脉支架置入术后再狭窄的相关危险因素。方法 对我院行冠状动脉支架置入并行冠状动脉造影随访患者171例的临床资料进行回顾性分析。根据造影随访结果其中术后48例患者中的56支靶血管发生再狭窄作为病例组,未发生再狭窄患者123例,133支血管作为对照组。先采用Pearson卡方单因素分析,将单因素分析存在统计学差异的临床变量纳入Logistic回归方程,计算冠状动脉支架置入术后再狭窄的独立危险因素。结果 单因素分析显示:术前狭窄程度>90%(χ24.71,P0.03)、支架直径≤3 mm (χ227.92,P0.00)、病变长度>15 mm(χ24.67,P0.03)、残余狭窄>5%(χ210.05,P0.00)、吸烟患者(χ24.78,P0.03)、糖尿病患者(χ24.72,P0.03)和术后不规范抗凝(χ26.70,P0.01)与术后支架内再狭窄有关;Logistic回归分析显示支架直径≤3 mm (OR4.34, 95%CI: 2.01~8.38,P0.02)、残余狭窄>5%(OR2.2, 95%CI: 1.56~4.88,P0.03)和术后不规范抗凝(OR1.88, 95%CI:1.21~3.68,P0.04)是影响冠状动脉术后再狭窄的独立危险因素。风险比例模型显示,置入支架直径≤3 mm患者随访期间发生再狭窄的风险显著高于支架直径>3 mm患者(HR3.53, 95%CI:2.08~5.99, P0.00)。结论 置入支架直径较小、残余狭窄较重且术后抗凝不规范的患者是支架植入术后再狭窄的危险人群,应加强监测,规范抗凝,降低其再狭窄的发生风险。

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    Aim To evaluate the independent risk factors for restenosis in patients treatment of coronary stenting. Methods One hundred and seventy one patients who underwent the coronary stent implantation with a follow-up of angiography from July 2009 to November 2011 were included in this retrospective study. Among the 171 subjects, 48 patients with 56 target diagnosed of restenosis according to the angiography were defined as case group, and 123 patients with 133 target vessels without restenosis were deemed as control group. The logistic regression model was applied to evaluate the independent risk factors for restenosis in patients treatment of coronary stenting. Results Univariate analysis showed that Univariate analysis showed that stenosis prior PCI >90% (χ24.71,P0.03), diameter of the stent ≤3 mm (χ227.92,P0.00), length of the leision>15 mm (χ24.67,P0.03), residual stenosis >5%(χ210.05,P0.00), smoking (χ24.78,P0.03), diabetes (χ24.72,P0.03), irregular anticoagulation(χ26.70,P0.01) were associated with restenosis in patients treated with coronary stenting. Logistic regression demonstrated that diameter of the stent ≤3 mm (OR4.34, 95%CI:2.01~8.38,P0.02), residual stenosis >5% (OR2.2, 95%CI: 1.56~4.88,P0.03) and irregular anticoagulation (OR1.88, 95%CI:1.21~3.68,P0.04) were the independent risk factors for restenosis. And the proportional hazards model showed patients with diameter of the stent ≤3 mm had the higher risk for restenosis than that with >3 mm (HR3.53, 95%CI:2.08~5.99, P0.00) . Conclusion Patients treated with smoler diameter stent, serious residual stenosis and irregular anticoagulation had the higher risk to develop restenosis after coronary stenting and this kind of patients should be taken seriously.

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梁祥文, 李 平, 甘剑挺, 王正东, 陈 坚, 谢文超.冠状动脉支架置入后再狭窄危险因素的Logistic回归分析[J].中国动脉硬化杂志,2014,22(03):283~286.

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  • 收稿日期:2013-06-30
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