介入治疗后冠状动脉再狭窄与冠心病易患因素吸烟关系分析

目的 探讨国人冠心病介入治疗后再狭窄与冠心病易患因素吸烟关系。方法 冠心病介入治疗３５２例中，选择连续６５例（８６个冠脉狭窄病变）术后３～１６个月随访重复冠脉造影者，冠脉定量分析（ＱＣＡ）术前、术后和随访复查冠脉造影图象，并分析再狭窄发生率及随访时内径丢失与冠心病易患因素的关系。结果 再狭窄发生时间与吸烟史、多个易患因素、多支病变、病变类型、前降支病变、随访期尿酸呈正性相关，与支架置入呈负性相关，

Risk factors of coronary heart disease and restenosis after transluminal coronary angioplasty and coronary stenting

Objective To determine the risk factors, cigarette smoking in relation to restenosis after coronaryangioplasty. Methods Quantitative coronary analysis and angiographic characteristics of the lesions were determined in65 patients with angiographies in pre-and txost-intervention and during follow-up in all 352 patients with coronary an-gioplasty or coronary stenting. Angiographic restenosis was defined as at least 50 % of the luminal diameter wasstenosed which was seen on the follow-up angiogram after initial successful procedure. A multivariate Cox regressionanalysis was performed to assess the factors correlated with restenosis. Results Restenosis was correlated positivelywith pre-procedure smoking, multiple vulnerable factors, several vessels involvement, types of lesion, LDA involve-ment, and uric acid level during follow-up, but negatively with stent implantation. The cumulative rate of restenosis(88.33% ) during 16 months follow-up in 27 smoking patients(37 lesions) was higher than that in 38 non-smoking pa-tients (49 lesions, 66.49% by Kaplan-Meier method and log-rank test, P＜ 0.05). The smoking patients had smallerminimal luminal diameter and late loss of lumen than non-smokers. Conclusion Restenosis after angioplasty correlatesclosely with multiple risk factors, in particular, the smoking. (Shanghai Med J, 2000,23:461-464)