CAJ | 학술논문

目的：探讨冠心病患者冠状动脉支架植入术后支架内再狭窄（ ISR）的影响因素。方法选取冠心病行经皮冠状动脉介入治疗（ PCI）患者120例，均于6～12个月内行冠状动脉造影（ CAG）复查，根据是否发生ISR分为ISR组32例和无ISR组88例，观察两组一般资料、靶血管病变和支架特征、支架置入前左室射血分数及临床血清学指标，分析ISR发生的相关影响因素。结果 ISR组有吸烟史、糖尿病患者比例及纤维蛋白原（FIB）水平高于无ISR组（P＜0.05或P＜0.01）；冠状动脉Gensini积分、术前狭窄程度、支架长度大于无ISR组（P＜0.05或P＜0.01），支架直径小于无ISR组（P＜0.05）；Logis-tic回归分析显示，吸烟、糖尿病、冠状动脉Gensini积分和术前狭窄程度及支架长度较大是ISR发生的危险因素，支架直径较大是ISR发生的保护因素。结论吸烟、糖尿病、冠状动脉Gensini积分和术前狭窄程度、支架长度和直径与ISR的发生相关。
목적：탐토관심병환자관상동맥지가식입술후지가내재협착（ ISR）적영향인소。방법선취관심병행경피관상동맥개입치료（ PCI）환자120례，균우6～12개월내행관상동맥조영（ CAG）복사，근거시부발생ISR분위ISR조32례화무ISR조88례，관찰량조일반자료、파혈관병변화지가특정、지가치입전좌실사혈분수급림상혈청학지표，분석ISR발생적상관영향인소。결과 ISR조유흡연사、당뇨병환자비례급섬유단백원（FIB）수평고우무ISR조（P＜0.05혹P＜0.01）；관상동맥Gensini적분、술전협착정도、지가장도대우무ISR조（P＜0.05혹P＜0.01），지가직경소우무ISR조（P＜0.05）；Logis-tic회귀분석현시，흡연、당뇨병、관상동맥Gensini적분화술전협착정도급지가장도교대시ISR발생적위험인소，지가직경교대시ISR발생적보호인소。결론흡연、당뇨병、관상동맥Gensini적분화술전협착정도、지가장도화직경여ISR적발생상관。
Objectives To explore the influencing factors of postoperative in-stent restenosis ( ISR) after coronary stent implan-tation in patients with coronary heart disease ( CHD).Methods A total of 120 CHD patients undergoing percutaneous coronary in-tervention ( PCI) were selected and given reexamination with coronary angiography ( CAG) within 6~12 months.All patients were divided into ISR group (32 cases) and non-ISR group (88 cases) according to the presence of ISR.The clinical data, the charac-teristics of target vascular lesion and intents, left ventricular ejection fraction ( LVEF) before intent implantation and clinical serum indexes of both groups were observed, and ISR-associated relevant influencing factors were analyzed.Results ISR group was evi-dently higher in the ratio of patients with smoking history and diabetes and the fibrinogen ( FIB) level ( P<0.05 or P<0.01) , ob-viously larger in coronary artery Gensini score, preoperative stenosis severity and intent length (P<0.05 or P<0.01), but marked-ly less in intent diameter than non-ISR group (P<0.05).Logistic regression analysis showed that smoking, diabetes, coronary ar-tery Gensini score and larger preoperative stenosis severity and intent length were the risk factors while longer intent diameter the protective factor for the development of ISR.Conclusions Smoking, diabetes, coronary artery Gensini score, preoperative stenosis severity and intent length and diameter are in close association with the development of ISR.