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目的探讨冠心病合并2型糖尿病患者冠状动脉支架置入术(PCI)后支架内再狭窄的相关危险因素。方法对196例冠心病合并2型糖尿病患者于PCI后1年行冠状动脉造影。收集43例(49支血管)出现支架内再狭窄(再狭窄组,支架置入段血管内径狭窄≥50%)和153例未出现狭窄者(未狭窄组)的一般资料(年龄、吸烟史,高血压、高血脂心肌梗死病史等)、血生化指标(总胆固醇、甘油三酯、低密度脂蛋白、高密度脂蛋白、尿酸、血清总胆红素、纤维蛋白原)、病变血管情况(血管病变部位和支数)及支架置入情况(支架的直径、长度和数量)。采用Logistic多因素回归分析法分析冠状动脉支架内再狭窄相关因素。结果再狭窄组支架直径小于未狭窄组,尿酸、纤维蛋白原水平高于未狭窄组(P均<0.05);多因素Logistic回归分析显示,高纤维蛋白原、尿酸水平及较小的支架直径是冠状动脉支架内再狭窄的危险因素。结论高尿酸、纤维蛋白原水平及较小的支架直径为冠心病合并2型糖尿病患者PCI后支架内再狭窄的危险因素。
Objective To investigate the risk factors of in-stent restenosis after coronary stenting (PCI) in patients with coronary heart disease complicated with type 2 diabetes mellitus. Methods One hundred and sixteen patients with coronary heart disease and type 2 diabetes underwent coronary angiography 1 year after PCI. A total of 43 patients (49 vessels) with general data on restenosis (restenosis group, stent diameter ≥50%) and 153 patients without stenosis (stenosis group) (age, smoking history, Hypertension, history of hyperlipemic myocardial infarction, etc.), blood biochemical indicators (total cholesterol, triglycerides, low density lipoprotein, high density lipoprotein, uric acid, total serum bilirubin, fibrinogen) Lesion location and count) and stent placement (stent diameter, length and number). Logistic regression analysis was used to analyze the related factors of coronary stent restenosis. Results The diameter of scaffold in restenosis group was smaller than that in non-stenosis group, and the levels of uric acid and fibrinogen were higher in non-stenosis group than those in non-stenosis group (all P <0.05). Multivariate Logistic regression analysis showed that high fibrinogen, uric acid level and smaller stent diameter Risk factors for restenosis in coronary stents. Conclusions High uric acid, fibrinogen level and smaller stent diameter are the risk factors for in-stent restenosis in patients with type 2 diabetes mellitus after coronary heart disease.