【摘要】 目的分析慢性冠状动脉闭塞病变患者冠状动脉侧支循环形成的影响因素。方法采用双中心回顾性的方法分析温州医学院附属台州医院及中山大学孙逸仙纪念医院住院的慢性冠状动脉闭塞患者143例的临床资料,根据Rentrop and Cohen分级法对侧支循环形成情况进行分级,并根据分级水平将患者分为侧支循环不良组(0级与1级)与侧支循环良好组(2级和3级)。结果两组年龄、性别、高血压、饮酒、心肌梗死、缺血性脑卒中及总胆固醇、低密度脂蛋白胆固醇、肌钙蛋白T浓度等比较,差异无统计学意义(P>0.05);而两组吸烟、糖尿病及血肌酐、空腹血糖、血红蛋白、高敏C反应蛋白浓度比较,差异有统计学意义(P<0.05)。两组血管闭塞支数比例及靶血管闭塞比例比较,差异均无统计学意义(P>0.05)。以Rentrop and Cohen分级为因变量,以年龄、性别、原发性高血压、糖尿病、血脂浓度、超敏C-反应蛋白、估算的肾小球率过滤(estimated glomerular filtrationrate,eGFR)为自变量进行Logistic回归分析,结果显示糖尿病(OR=1.24,95%CI:1.12～1.41)及eGFR(OR=1.12,95%CI:1.23～1.52)入选回归方程。结论合并糖尿病或肾功能不全的慢性冠状动脉闭塞患者侧支循环差,而糖尿病及肾功能不全可能是影响侧支循环形成的重要因素。更多还原

【Abstract】 Objectives To analyze the influence factors on formation of coronary collateral circulation in patients with coronary chronic total occlusion(CTO).Methods A total of 143 CTO patients from Taizhou Affiliated Hospital of Wenzhou Medical College and Sun Yat-Sen Memorial Hospital Sun Yat-Sen University were enrolled in the study,and retrospective analysis was performed.All the patients were divided into two groups according to Cohen-Rentrop classification,namely unsatisfactory collateral circulation group(UCC,grade 0 and 1) and satisfactory collateral circulation group(SCC,grade 2 and 3).Results There were no significant differences in age,gender,hypertension,drinking,myocardial infarction,cerebral ischemic stroke,total cholesterol,low density lipoprotein cholesterol,troponin T between UCC group and SCC group(P>0.05);while there were significant differences in smoking,diabetes,serum creatinine,fasting serum glucose,hemoglobin,high-sensitivity C-reactive protein between UCC group and SCC group(P<0.05).There was no significant difference in proportion of single,dual,trinal coronary artery occlusion and target vascular occlusion between UCC group and SCC group(P>0.05).Setting Cohen-Rentrop classification as the dependent variable,and age,gender,hypertension,diabetes,plasma lipid concentrations,high-sensitivity C-reactive protein,estimated glomerular filtration rate(eGFR) as the independent variables,multi-factor Logistic regression analysis demonstrated that eGFR(OR=1.12,95% CI:1.23-1.52) and diabetes(OR=1.24,95% CI:1.12-1.41) entered into the regression equation.Conclusions Coronary collateral circulation is worse in patients with coronary chronic total occlusion combined with diabetes or kidney insufficiency.Diabetes and kidney insufficiency may be the important factors on formation of coronary collateral circulation.更多还原