CAJ | 학술논문

目的：研究冠心病患者冠脉内植入雷帕霉素药物洗脱支架（SES）一年支架内再狭窄（ISR ）的影响因素。方法：2012年1月1日到2013年12月30日在我科住院已植入雷帕霉素药物洗脱支架（SES）并1年后复查冠脉造影患者275例，根据冠脉造影结果分为无再狭窄组（247例）和再狭窄组（38例）。比较两组之间临床特征的差异，并通过Logistic回归分析ISR的影响因素。结果：与无再狭窄组比较，再狭窄组闭塞病变（17.9％比31.9％）、支架重叠（16.7％比31.9％）比例明显增加，支架后扩张比例（34.9％比10.6％）明显减小（ P＜0.05或 P＜0.01）；Logistic回归分析显示，冠脉闭塞病变（OR ：2.855，95％ CI ：1.197～6.808， P＝0.018）是发生ISR的危险因素，支架后扩张是发生ISR的保护因素（OR ：0.198，95％ CI ：0.057～0.691，P＝0.011）。结论：冠脉闭塞病变和支架重叠可增加支架内一年再狭窄率；支架后扩张能减少支架内一年再狭窄率；而且冠脉闭塞病变是冠脉内植入药物洗脱支架后一年再狭窄危险因素，支架后扩张是其保护因素（预防因素）。
목적：연구관심병환자관맥내식입뢰파매소약물세탈지가（SES）일년지가내재협착（ISR ）적영향인소。방법：2012년1월1일도2013년12월30일재아과주원이식입뢰파매소약물세탈지가（SES）병1년후복사관맥조영환자275례，근거관맥조영결과분위무재협착조（247례）화재협착조（38례）。비교량조지간림상특정적차이，병통과Logistic회귀분석ISR적영향인소。결과：여무재협착조비교，재협착조폐새병변（17.9％비31.9％）、지가중첩（16.7％비31.9％）비례명현증가，지가후확장비례（34.9％비10.6％）명현감소（ P＜0.05혹 P＜0.01）；Logistic회귀분석현시，관맥폐새병변（OR ：2.855，95％ CI ：1.197～6.808， P＝0.018）시발생ISR적위험인소，지가후확장시발생ISR적보호인소（OR ：0.198，95％ CI ：0.057～0.691，P＝0.011）。결론：관맥폐새병변화지가중첩가증가지가내일년재협착솔；지가후확장능감소지가내일년재협착솔；이차관맥폐새병변시관맥내식입약물세탈지가후일년재협착위험인소，지가후확장시기보호인소（예방인소）。
Objective:To study influencing factors for in‐stent restenosis (ISR) during one year in patients with coro‐nary heart disease (CHD) after coronary sirolimus‐eluting stent (SES) implantation .Methods :According to results of coronary angiography (CAG) ,a total of 275 patients ,who hospitalized in our department from Jan 1st ,2012 to Dec 30th ,2013 and have received SES implantation and reviewed CAG after one year ,were divided into non‐ ISR group (n=247) and ISR group (n=38) .Clinical characteristics were compared between two groups ,and Logistic regression analysis was used to analyze influencing factors for ISR .Results:Compared with non‐ISR group ,there were significant rise in percentages of occlusion lesions (17. 9% vs .31. 9% ) ,multiple overlapping stents (16. 7% vs . 31.9% ) ,and significant reduction in percentage of stent post‐dilatation (34.9% vs .10.6% ) in ISR group ,P<0.05 or <0. 01 ;Logistic regression analysis indicated that coronary occlusion lesion was a risk factor (OR :2. 855 ,95%CI :1.197~6.808 ,P=0.018) ,and post‐dilatation was a protective factor (OR :0.198 ,95% CI :0.057~0.691 , P=0.011) for ISR occurrence .Conclusion:Multiple overlapping stents and coronary occlusion lesions increase one‐year in‐stent restenosis rate ;stent post‐dilatation can reduce one‐year in‐stent restenosis rate ;coronary occlusion le‐sions is a risk factor , and stent post‐dilatation is a protective factor for restenosis during one‐year after coronary drug‐eluting stent implantation .