2024 年第 5 期 第 0 卷

冠心病合并糖尿病患者经皮冠状动脉介入术后支架内再狭窄危险因素的研究进展

Research progress on risk factors of in-stent restenosis in patients with coronary atherosclerotic heart disease and diabetes mellitus after percutaneous coronary intervention

作者：罗鸿池1 马涵英1 韩红亚2 李亚冬1 刘晓丽2 赵铁夫1

英文作者：Luo Hongchi1 Ma Hanying1 Han Hongya2 Li Yadong1 Liu Xiaoli2 Zhao Tiefu1

单位：1首都医科大学附属北京安贞医院全科医疗科，北京100029；2首都医科大学附属北京安贞医院老年心血管病中心，北京100029

英文单位：1Department of General Medicine Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2Elderly Cardiovascular Center Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：冠心病（冠状动脉粥样硬化性心脏病）；糖尿病；支架内再狭窄；经皮冠状动脉介入；危险因素

英文关键词：Coronaryatheroscleroticheartdisease;Diabetesmellitus;In-stentrestenosis;Percutaneouscoronaryintervention;Riskfactors

• 摘要：

• 冠心病（冠状动脉粥样硬化性心脏病）合并糖尿病患者冠状动脉支架内再狭窄率显著高于未合并糖尿病患者。其特征以糖代谢异常、血糖波动、胰岛素抵抗为核心，且往往伴发高脂血症、高尿酸血症、凝血及纤维蛋白溶解指标异常、慢性炎症等，这些因素直接或间接影响了血管内皮功能，促使平滑肌增生、凝血异常等，并最终导致再狭窄的发生。本综述主要针对糖尿病合并冠心病患者经皮冠状动脉介入术后支架内再狭窄危险因素的研究进行总结探讨，以期为临床降低支架内再狭窄发生率及预防不良心血管事件的发生提供参考依据。

• The rate of in-stent restenosis in patients with coronary atherosclerotic heart disease and diabetes mellitus is significantly higher than that in patients without diabetes mellitus. It is characterized by abnormal glucose metabolism, blood glucose fluctuation, insulin resistance as the core, and is often accompanied by hyperlipidemia, hyperuricemia, abnormal coagulation and fibrinolysis indicators, chronic inflammation, etc. These factors directly or indirectly affect vascular endothelial function, promote smooth muscle proliferation, abnormal coagulation, and ultimately lead to the occurrence of restenosis. This review mainly summarizes and discusses the research on the risk factors of in-stent restenosis after percutaneous coronary intervention in patients with diabetes mellitus and coronary atherosclerotic heart disease, in order to provide a reference for reducing the incidence of in-stent restenosis and preventing the occurrence of adverse cardiovascular events.