作者：曾翔1 ，李军文2 ，王昆1 ，郭雅乐3 ，王兆兰3

单位：

1.610599四川省成都市，成都医学院　2.610071四川省成都市第一人民医院护理部　3.610075四川省成都 市，成都中医药大学

Units：

1.Chengdu Medical College, Chengdu 610599, China 2.Nursing Department, Chengdu First People's Hospital, Chengdu 610071, China 3.Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China

关键词：

　冠心病；经皮冠状动脉介入治疗；支架内再狭窄；影响因素分析；Meta分析

Keywords：

　Coronary disease; Percutaneous coronary intervention; In-stent restenosis; Root cause analysis; Meta analysis

CLC：

R 541.4

DOI：

10.12114/j.issn.1008-5971.2024.00.032

Funds：

四川省2022年重点研发计划项目（2022JDKP0019）

摘要：

目的　系统评价中国冠心病患者PCI后发生支架内再狭窄（ISR）的影响因素。方法　计算机检索中 国知网、万方数据知识服务平台、维普网、中国生物医学文献数据库、PubMed、Web of Science、Cochrane Library、 Embase中公开发表的关于中国冠心病患者PCI后发生ISR影响因素的病例对照研究和队列研究，检索时限自建库至2023 年10月。病例组为发生ISR患者，对照组为未发生ISR患者。采用Stata 12.0软件进行Meta分析。结果　最终纳入12篇 文献，均为病例对照研究，包括4 145例患者，其中病例组891例、对照组3 254例；12篇文献均为高质量文献。Meta 分析结果显示，年龄〔OR=1.034，95%CI（1.005～1.065）〕、糖尿病史〔OR=2.053，95%CI（1.737～2.427）〕、 术后吸烟〔OR=1.646，95%CI（1.396～1.927）〕、支架直径〔OR=0.711，95%CI（0.633～0.799）〕、支架长 度〔OR=1.047，95%CI（1.021～1.073）〕、支架数量〔OR=2.177，95%CI（1.384～3.425）〕是中国冠心病患者PCI后 发生ISR的影响因素（P＜0.05）。结论　年龄增长、糖尿病史、支架长度较长、术后吸烟、支架数量较多是中国冠心 病患者PCI后发生ISR的危险因素，支架直径较大是其保护因素。

Abstract：

Objective To systematically evaluate the influencing factors of in-stent restenosis (ISR) after PCI in Chinese patients with coronary heart disease. Methods Case-control studies and cohort studies on the influencing factors of ISR after PCI in Chinese patients with coronary heart disease published in CNKI, Wanfang Data, VIP, Chinese Biomedical Literature Database, PubMed, Web of Science, Cochrane Library and Embase were retrieved by computer. The retrieval time was from the establishment of the database to October 2023. The case group consisted of patients with ISR, and the control group consisted of patients without ISR. Meta-analysis was performed using Stata 12.0 software. Results Finally, 12 articles were included, all of which were case-control studies, including 4 145 patients (including 891 cases in the case group and 3 254 cases in the control group) . All the 12 articles were of high quality. The results of Meta-analysis showed that age [OR= 1.034, 95%CI (1.005-1.065) ] , history of diabetes [OR=2.053, 95%CI (1.737-2.427) ] , postoperative smoking [OR=1.640, 95%CI (1.396-1.927) ] , stent diameter [OR=0.711, 95%CI (0.633-0.799) ] , stent length [OR=1.047, 95%CI (1.021-1.073) ] , number of stents [OR=2.177, 95 %CI (1.384-3.425) ] were the influencing factors of ISR after PCI in Chinese patients with coronary heart disease ( P < 0.05) . Conclusion Increased age, history of diabetes, postoperative smoking, longer stent length, and larger number of stents are risk factors for ISR after PCI in Chinese patients with coronary heart disease, and bigger stent diameter is a protective factor.

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