本文關(guān)鍵詞：血脂控制水平與支架置入術(shù)后冠脈支架內(nèi)再狹窄的相關(guān)性研究　出處：《蘭州大學(xué)》2015年碩士論文　論文類型：學(xué)位論文

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【摘要】：目的本研究通過分析冠心病患者行PCI術(shù)前血脂水平與術(shù)后3-12月期間再次復(fù)查時(shí)血脂水平,探討血脂控制水平與冠狀動(dòng)脈介入治療術(shù)后支架內(nèi)再狹窄的相關(guān)性。方法收集2012年1月至2012年12月在蘭州大學(xué)第一醫(yī)院心臟中心住院首次行PCI的冠心病患者211例,所有患者均常規(guī)口服雙聯(lián)抗血小板、他汀類藥物,并于術(shù)后3月至12月再次入院行冠狀動(dòng)脈造影,根據(jù)造影結(jié)果分為兩組,其中再狹窄組25例,無再狹窄組186例,所有入選患者于PCI術(shù)前及復(fù)查造影時(shí)采集外周靜脈血,使用全自動(dòng)生化分析儀檢測總膽固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白,定量分析兩次血脂水平,探討其與冠脈支架內(nèi)再狹窄的關(guān)系。結(jié)果兩組患者中年齡、性別、高血壓患病率、冠心病家族史、術(shù)前診斷急性冠脈綜合癥(Acute coronary syndrom,ACS)、吸煙、飲酒比例差異均無統(tǒng)計(jì)學(xué)意義P0.05),PCI術(shù)前總膽固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白水平差異均無統(tǒng)計(jì)學(xué)意義(P0.05)；合并糖尿病患者再狹窄組(9/25)較無再狹窄組(33/186)差異有統(tǒng)計(jì)學(xué)意義(P=0.03)；經(jīng)Logistic多因素逐步回歸分析顯示低密度脂蛋白未控制在1.8mmol/L以下或較前未下降50%(比值比=0.09,95%可信區(qū)間：0.03-0.28,P0.01)、總膽固醇未下降(比值比=3.83,95%可信區(qū)間：1.07-13.62,P=0.04)、合并糖尿病(比值比=0.33,95%可信區(qū)間：0.11-0.94,P=0.04)與支架內(nèi)再狹窄有正相關(guān)性。結(jié)論冠心病患者行PCI術(shù)后,常規(guī)口服雙聯(lián)抗血小板聚集、他汀類藥物治療,總膽固醇未下降、低密度脂蛋白未達(dá)標(biāo)是后期支架內(nèi)再狹窄發(fā)生的高危因素,合并糖尿病患者行PCI術(shù)后發(fā)生支架內(nèi)再狹窄的幾率明顯增高。
[Abstract]:Objective to analyze the serum lipid levels before and after PCI in patients with coronary heart disease (CHD). To investigate the correlation between blood lipid control level and stent restenosis after coronary intervention. Methods PC was performed for the first time from January 2012 to December 2012 in the heart center of the first Hospital of Lanzhou University. There were 211 patients with coronary heart disease. All patients were routinely given dual antiplatelet and statins, and were re-admitted to hospital from March to December. According to the results of coronary angiography, they were divided into two groups, including 25 patients in restenosis group. In the non-restenosis group, peripheral venous blood was collected before and after PCI, and total cholesterol, triglyceride and high density lipoprotein were detected by automatic biochemical analyzer. Low density lipoprotein (LDL), quantitative analysis of blood lipid levels twice, to explore its relationship with coronary stent restenosis. Results the two groups of patients in age, sex, prevalence of hypertension, coronary heart disease family history. There was no significant difference in the proportion of smoking and drinking in the diagnosis of acute coronary syndrome before operation (P 0.05). There was no significant difference in total cholesterol, triglyceride, high density lipoprotein and low density lipoprotein before PCI. There was a statistically significant difference between the restenosis group (n = 9 / 25) and the non-restenosis group (n = 33 / 186). Logistic multivariate stepwise regression analysis showed that LDL was not controlled below 1.8 mmol / L or did not decrease by 50% (ratio = 0.09). The confidence interval of 95%: 0.03-0.28% P0.01g, total cholesterol did not decrease (the ratio was 3.83% 95% CI: 1.07-13.62% P0.04). There was a positive correlation between the ratio of diabetes mellitus (0.33% 95% CI: 0.11-0.94) and restenosis in stent. Conclusion patients with coronary heart disease underwent PCI operation. Routine oral dual anti-platelet aggregation, statins drug treatment, total cholesterol did not decrease, low density lipoprotein is not up to standard is the risk factor of restenosis in stent. The incidence of stent restenosis after PCI was significantly increased in patients with diabetes mellitus.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R541.4

【參考文獻(xiàn)】

相關(guān)期刊論文 前1條

1 張莉莉,賈國良,王海昌,郭文怡,馬蘭香,孫玉波;抗血小板藥物對(duì)冠心病支架植入術(shù)后再狹窄防治效果的觀察[J];心臟雜志;2004年05期

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本文編號(hào)：1359523