新疆维吾尔族和哈萨克族冠心病患者经皮冠状动脉介入治疗术支架内亚急性血栓形成因素分析Causes of subacute coronary stent thrombosis among different races in XinJiang province: a report of 21 cases
黄定,马依彤,杨毅宁,再帕尔,王疆,刘晓,王新华,张红
摘要(Abstract):
目的探讨支架内亚急性血栓形成民族差异的原因和防治策略。方法回顾性地对术后发生支架内亚急性血栓(subacutestentthrombosis,SST)形成的21例不同民族(汉族、维吾尔族、哈萨克族)患者的血液流变学、凝血机制、血管病变特点、手术操作过程和治疗措施等资料进行分析,采用单因素和Logistic多因素逐步回归分析。结果维吾尔族和哈萨克族经皮冠状动脉介入治疗(percuta-neouscoronaryinterventions,PCI)患者中SST发生率明显高于汉族患者(1.4%比0.47%;5.4%比0.47%,P均<0.05)。维吾尔族和哈萨克族SST患者术前血浆纤维蛋白原、全血黏度低切及血浆比黏度较汉族明显增高(P均<0.05);多因素分析民族,血浆纤维蛋白原水平是SST的独立危险因素,比数比(OR)分别为1.043和1.018。结论PCI术后SST发生率可能存在民族差异,其原因可能与种族间凝血机制差异导致的高凝状态有关,在常规治疗的基础上,适当应用降低血浆纤维蛋白原含量的药物,可能助于预防SST的形成。
关键词(KeyWords): 冠状动脉疾病;血栓形成;血管成形术,经腔,经皮冠状动脉
基金项目(Foundation):
作者(Author): 黄定,马依彤,杨毅宁,再帕尔,王疆,刘晓,王新华,张红
参考文献(References):
- [1]Mak KH,Belli G,Ellis SG,et al.Subacute stent thrombosis;evolvingissues and current concepts.J AmColl Cardiol,1996,27:493-494.
- [2]Edouard C,Laurent L,Gary SM,et al.Predictors of Subacute Stent Thrombosis Results of a Systematic Intravascular Ultrasound Study.Circulation,2003,108:43-47.
- [3]Karrillon GJ,Morice MC,Benveniste E,et al.Intracoronary stent implantation without ultrasound guidance and withreplacement of con-ventional anticoagulation by antiplatelet therapy.30-day clinical out-come of the French Multicenter Registry.Circulation,1996,94:1519-1527.
- [4]Cutlip DE,BaimDS,Ho KK,et al.Stent thrombosisinthe modern era:a pooled analysis of multicenter coronary stent clinical trials.Circulation,2001,103:1967-1971.
- [5]Orford JL,Lennon R,Melby S,et al.Frequency and correlates of coronary stent thrombosisinthe modern era:analysis of a single cen-ter registry.J AmColl Cardiol,2002,40:1567-1572.
- [6]Gum PA,Kottke-Marchant K,Welsh PA,et al.A prospec-tive,blinded determination of the natural history of aspirin resistance among stable patients withcardiovascular disease.J AmColl Cardiol,2003,41:961-965.
- [7]Barragan P,Bouvier JL,Roquebert PO,et al.Resistance to thien-opyridines:clinical detection of coronarystent thrombosis by monitor-ing of vasodilator-stimulated phosphoprotein phosphorylation.Catheter Cardiovasc Interv,2003,59:295-302.
- [8]Kastrati A,Koch W,Gawaz M,et al.PlApolymorphismof glycop-rotein IIIa andriskof adverse events after coronarystent placement.J AmColl Cardiol,2000,36:84-89.
- [9]龚庆华,黄雪芳.129例正常维吾尔族成人血流变检测分析.中国血液流变学杂志,1996,6:52-53.
- [10]郦娜,于戈群.38例维吾尔族心绞痛伴高黏血症患者血流变观察.中国血液流变学杂志,2003,13:264.
- [11]马艳,张庆华.新疆维吾尔族正常人群抗活化的蛋白C发生率的调查.中华血液病杂志,1996,17:468.
- [12]Peter W,Christoph R,Franz RE,et al.Stent thrombosis following bare-metal stent implantation:success of emergency percutaneous coronaryinterventionand predictors of adverse outcome.Eur Heart J,2005,23:1-8.