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目的:分析药物洗脱支架(DES)置入术后支架内血栓形成(ST)的相关危险因素。方法:回顾性分析我院2013年1月至2016年6月间,因急性冠状动脉综合征(ACS)接受DES置入术的患者的临床资料,将术后发生ST的81例患者作为实验组,并按年龄、性别匹配同期未出现ST的患者243例(1∶3)作为对照组。比较两组临床资料,应用条件Logistic回归模型对支架内血栓形成进行风险评估。结果:条件Logistic回归分析确定DES置入术后ST的独立危险因素为:自身免疫性疾病(OR=120.078,95%CI=1.386~10404.459,P=0.035)、首发为急性心肌梗死(OR=14.085,95%CI=2.215~89.573,P=0.005)、左心室射血分数(LVEF)<50%(OR=19.985,95%CI=2.945~135.630,P=0.002)、空腹血糖(OR=1.977,95%CI=1.281~3.053,P=0.002)。结论:研究提示,自身免疫性疾病、首发为急性心肌梗死、LVEF<50%、空腹血糖升高是DES置入术后发生ST的独立危险因素。
Objective: To analyze the related risk factors of stent thrombosis (ST) after drug-eluting stent (DES) implantation. Methods: The clinical data of patients undergoing DES implantation in acute coronary syndrome (ACS) between January 2013 and June 2016 in our hospital were retrospectively analyzed. The 81 patients with postoperative ST were selected as the experimental group , And 243 patients (1: 3) who did not appear ST in the same period according to their age and gender were selected as the control group. The clinical data of two groups were compared and the risk of stent thrombosis was assessed using conditional logistic regression model. Results: Logistic regression analysis showed that the independent risk factors for ST after DES were as follows: autoimmune diseases (OR = 120.078, 95% CI = 1.386-10404.459, P = 0.035) (OR = 19.985, 95% CI = 2.945-135.630, P = 0.002), fasting blood glucose (OR = 1.977, 95% CI = 1.281-3.053, P = 0.002). CONCLUSIONS: The study suggests that autoimmune diseases, with first onset of AMI, LVEF <50%, and elevated fasting plasma glucose, are independent risk factors for ST after DES implantation.