CAJ | 학술논문

目的：分析经皮冠状动脉支架置入术（PCI）后再次血运重建的冠脉病变特征，探寻不同部位冠脉病变再次血运重建的相关危险因素。方法收集徐州医学院附属医院2011年3月~2012年12月所有接受药物洗脱支架（DES）置入的患者，筛选出再次行冠脉造影（CAG）复查患者293例，平均首次PCI-再次CAG时间（10.77±4.82）个月。根据冠脉造影结果是否需再次血运重建将上述患者分为再次血运重建组（n=199）及CAG组（n=94）。回顾性分析两组患者相关临床资料的差异，探寻再次血运重建的危险因素。剔除再次血运重建组中混合病变病例后，根据病变部位将再次血运重建组患者分为靶病变再次血运重建（TLR）组（n=52）、靶血管再次血运重建（TVR）组（n=76）及非靶血管再次血运重建（NTVR）组（n=28）。进一步比较再次血运重建各亚组与CAG组及再次血运重建各亚组之间患者临床资料的差异。结果糖尿病、抽烟、低密度脂蛋白胆固醇（LDL-C）、支架总长度是所有PCI术后患者再次血运重建的独立危险因素。CAG组及再次血运重建各亚组患者在抽烟、LDL-C、支架总长度、多血管PCI史、分叉病变PCI史及首次PCI-再次CAG时间有显著差异。结论糖尿病史、抽烟、LDL-C、支架总长度是所有PCI术后患者再次血运重建的独立危险因素。 PCI术后再次血运重建病变类型不同，其临床资料差异显著。
목적：분석경피관상동맥지가치입술（PCI）후재차혈운중건적관맥병변특정，탐심불동부위관맥병변재차혈운중건적상관위험인소。방법수집서주의학원부속의원2011년3월~2012년12월소유접수약물세탈지가（DES）치입적환자，사선출재차행관맥조영（CAG）복사환자293례，평균수차PCI-재차CAG시간（10.77±4.82）개월。근거관맥조영결과시부수재차혈운중건장상술환자분위재차혈운중건조（n=199）급CAG조（n=94）。회고성분석량조환자상관림상자료적차이，탐심재차혈운중건적위험인소。척제재차혈운중건조중혼합병변병례후，근거병변부위장재차혈운중건조환자분위파병변재차혈운중건（TLR）조（n=52）、파혈관재차혈운중건（TVR）조（n=76）급비파혈관재차혈운중건（NTVR）조（n=28）。진일보비교재차혈운중건각아조여CAG조급재차혈운중건각아조지간환자림상자료적차이。결과당뇨병、추연、저밀도지단백담고순（LDL-C）、지가총장도시소유PCI술후환자재차혈운중건적독립위험인소。CAG조급재차혈운중건각아조환자재추연、LDL-C、지가총장도、다혈관PCI사、분차병변PCI사급수차PCI-재차CAG시간유현저차이。결론당뇨병사、추연、LDL-C、지가총장도시소유PCI술후환자재차혈운중건적독립위험인소。 PCI술후재차혈운중건병변류형불동，기림상자료차이현저。
Objective To analyze the characteristics of coronary lesions of repeat revascularization after percutaneous coronary intervention(PCI), and explore main risk factors of coronary artery disease for revascularization in different parts of the coronary lesions. Methods 293 patients accepted coronary angiography after undergoing drug-eluting stents implantation in the Affiliated Hospital of Xuzhou Medical College, the mean period of first PCI to second CAG was (10.77±4.82)months. Divid-ed the patients into coronary angiography group(n=94) and repeat revascularization group(n=199) according to the need for re-peat revascularization, and analyzed risk factors for repeat revascularization. Then divided patients who received repeat revascu-larization into target lesion group (n=52), target vessel group (n=76), and non-target vessel group (n=28) according to the le-sions, after excluding the cases who had mixed lesions. Further compared the differences on the clinical data of patients in sub-groups of repeat revascularization . Results Diabetes, smoking, low density lipoprotein cholesterol (LDL-C) levels, and total length of the stent were independent risk factors for repeat revascularization after PCI. Smoking, LDL-C levels, total length of the stent, history of PCI with multivessel revascularization,history of PCI with bifurcation and the period from first PCI to repeat CAG had significant differences between coronary angiography group and subgroups of repeat revascularization. Conclusion Diabetes, smoking, LDL-C levels and total length of the stent are independent risk factors for repeat revascularization after PCI. Patients who have different type of repeat revascularization after PCI have significant differences on clinical data.