| 王振,徐通达,李东野.冠心病合并糖尿病经皮冠状动脉介入治疗术后支架内再狭窄预测因素分析[J].安徽医药,2019,23(9):1821-1825. |
| 冠心病合并糖尿病经皮冠状动脉介入治疗术后支架内再狭窄预测因素分析 |
| Study on predictors of in-stent restenosis in patients with diabetes mellitus after PCI |
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| DOI：10.3969/j.issn.1009-6469.2019.09.031 |
| 中文关键词: 冠心病 糖尿病 经皮冠状动脉介入治疗 支架内再狭窄 预测因素 |
| 英文关键词: Coronary disease Diabetes mellitus Percutaneous coronary intervention In-stent restenosis Predictive factor |
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| 中文摘要: |
| 目的 分析冠心病合并糖尿病(DM)病人经皮冠状动脉介入治疗(PCI)术后，支架内再狭窄(ISR)的相关危险因素并探寻预测因素。方法 回顾性分析2016年1月至2018年5月徐州医科大学附属医院收治的冠心病合并糖尿病PCI术出院后6~36个月内再次入院行冠状动脉造影(CAG)病人128例。根据复查CAG是否发生ISR分为再狭窄(ISR)组23例和非再狭窄组(non-ISR)105例；(1)单因素分析比较ISR组与非ISR组的一般信息、造影特征、实验室检查结果及药物治疗方案；(2)对单因素分析有统计学意义(P＜0.05)的指标，按四分位法进行单因素组内比较，分析每个指标不同水平时是否差异有统计学意义；(3)以单因素分析中有统计学差异(P＜0.05)的指标为自变量，以ISR为因变量，进行二元logistic逐步回归分析，研究ISR的独立危险因素；(4)运用logistic回归方程评价回归分析得到的相关指标的预测价值。结果 (1)单因素分析示ISR组白细胞计数(WBC)(7.16±1.96)×109/L、低密度脂蛋白胆固醇(LDL-C)(2.85±0.76)mmol/L、D二聚体(DDi)(0.41±0.34)μg/mL、糖化血红蛋白(HbA1c)(8.85±1.06)%水平均高于non-ISR组［(6.30±1.54)×109/L、(2.18±0.67)mmol/L、(0.26±0.27)μg/mL、(7.57±0.81)%］，均差异有统计学意义(P＜0.05)。(2)logistic回归分析示HbA1c(OR＝3.854，95%CI 1.849-8.032)、LDL-C(OR＝2.502，95%CI 1.123-5.575)是支架内再狭窄的独立危险因素。(3)logistic回归方程示LDL-C每增加1 mmol/L，ISR发病的比例为2.648；HbA1c每增加1%，ISR发病的比例为4.249。结论 LDL-C及HbA1c是DM病人PCI术后ISR的独立危险因素，且LDL-C、HbA1c可以作为预测ISR的指标。 |
| 英文摘要: |
| Objective To investigate the predictors of in-stent restenosis (ISR) in patients with diabetes mellitus (DM) after percutaneous coronary intervention (PCI).Methods A retrospective analysis was performed on 128 patients with DM after PCI admitted to our hospital from January 2016 to May 2018，including 23 patients in the ISR group and 105 patients in the non-ISR group.Univariate analysis，univariate intra-group comparison，logistic stepwise regression model were used to analyze the related factors of ISR after PCI and explore the predictors.Results (1)The WBC(7.16±1.96)×109/L，LDL-C(2.85±0.76)mmol/L，DDi (0.41±0.34)μg/mLand HbA1c levels(8.85±1.06)% of the ISR group were higher than those of the non-ISR group［(6.30±1.54)×109/L，(2.18±0.67)mmol/L，(0.26±0.27)μg/mL，(7.57±0.81)%］ in univariate analysis，and the differences were statistically significant (P＜0.05).(2)Logistic regression analysis showed that HbA1c (OR＝3.854，95%CI 1.849-8.032) and LDL-C (OR＝2.502，95%CI 1.123-5.575) were risk factors for ISR.(3)Logistic regression equation showed that for every 1 mmol/L increase in LDL-C，the OR of ISR incidence was 2.648.For every 1% increase in HbA1c，the OR of ISR incidence was 4.249.Conclusion LDL-C and HbA1c are independent risk factors for in-stent restenosis in patients with DM after PCI，and LDL-C，HbA1c can be used as indicators to predict ISR. |
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