摘要
目的探讨冠状动脉旁路移植术(CABG)术后中远期桥血管闭塞的影响因素。方法回顾性分析行CABG术后冠状动脉CT血管成像(CTA)检查84例患者的临床资料及影像资料,运用单因素及多因素分析研究桥血管闭塞发生的影响因素。结果 84例(204支桥血管)中,桥血管闭塞45支(22.1%)。靶血管直径>2mm的闭塞率低于靶血管直径≤2mm(34.5%vs.53.9%)(P<0.01)。103支静脉桥中26支出现闭塞;其中,序贯吻合的静脉桥占69.2%,非序贯吻合占30.8%(P<0.05)。桥血管闭塞患者HDL-C<0.93mmol/L比例高于桥血管通畅患者(60.5%vs.37.0%)(P<0.05)。多因素Logistic回归分析显示,血清HDL-C降低为CABG术后桥血管闭塞的独立危险因素(P<0.05)。结论 CABG术后桥血管闭塞的相关因素有血清HDL-C、远端靶血管直径和静脉桥是否进行了序贯吻合。
Objective To explore the possible relevant risk factors for bypass graft occlusion in the patients underwent coronary artery bypass grafting（CABG）.Methods Clinical data of 84 patients underwent CABG were restropectively analyzed,who were followed up by coronary CT vascular imaging.Univariate and multivariate analysis were used to analyze the influencing factors of graft occlusion.Results Of 84 patients,38（45.2%）cases had graft occlusion.In 204 bypass grafts,45（22.1%）vessels were occluded.The occlusion rate of target vessels with diameter〉2 mm was lower than that of diameter≤2 mm（34.5% vs.53.9%）（P〈0.01）.Twenty-six branches of 103 venous grafts were occluded and venous grafts with plus anastomosis were vulnerable to be occluded（69.2%vs 30.8%）（P〈0.05）.In the patients with HDL-C〈0.93 mmol/L,the percentage of graft patency was lower than that of graft occlusion（37.0%vs.60.5%）（P〈0.05）.Multivariate Logistic regression analysis showed that decreased serum HDL-C was an independent risk factor for graft occlusion after CABG（P〈0.05）.Conclusion Serum HDL-C level,distal target vessel diameter and sequential anastomosis of venous grafts are closely related with bypass graft occlusion in the patients underwent CABG.
作者
黄蔚蔚
徐怡
朱晓梅
祝因苏
唐立钧
屠建春
HUANG Weiwei;XU Yi;ZHU Xiaomei(Department of Radiology, Kunshan Hospital of Traditional Chinese Medicine, Kunshan 215300, CHINA)
出处
《江苏医药》
CAS
2018年第5期559-562,共4页
Jiangsu Medical Journal
