关键词: 血管成形术, 气囊, 冠状动脉, 支架内再狭窄, 红细胞参数, 危险因素

Abstract: Background　In-stent restenosis（ISR） is an important factor associated with the short-term and long-term prognosis of patients undergoing precutaneous coronary intervention（PCI）. Finding clinical indicators to effectively evaluate ISR has the important clinical value. Some previous studies have found that red blood cell distribution width（RDW） is related to the occurrence of ISR，but there are few studies on the relationship between red blood cell parameters and ISR. Objective　To investigate the relationship between peripheral red blood cell parameters and the incidence of ISR. Methods　Peripheral blood routine results of patients with coronary atherosclerotic heart disease who underwent PCI and received coronary angiography follow up in Cardiovascular Medicine Department in Beijing Shijitan Hospital of Capital Medical University were collected，and clinical data may be related to ISR were analyzed. Results　One hundred and seventy patients were enrolled with an average age of（65.1±10.5） and an average follow-up period of（25.38±9.91） months. There were 213 PCI vessels，and among them，21 vessels were with ISR，with an incidence rate of 12.7%. The univariate analysis results showed that patients with ISR had smaller mean corpuscular volume（MCV）〔（89.11±3.70） fl vs.（91.64±4.07） fl，P=0.008〕，lower mean corpuscular hemoglobin（MCH）（29.76 pg vs. 31.10 pg，P=0.001），and lower mean corpuscular hemoglobin concentration（MCHC）〔（332.67±11.62） g/L vs.（338.21±10.55） g/L，P=0.027〕. There were no significant differences in the total number of red blood cells，hemoglobin concentration，and red blood cell distribution width in two groups（P>0.05）. Other test results showed that patients with ISR had a higher proportion of women and higher serum creatinine levels（P<0.05）. The results of coronary angiography and PCI showed that there was no significant difference in terms of the types of lesions，the involvement of blood vessels，the number of stents，the length of the stents，whether the lesion type was a bifurcation lesion，and whether the inflatable balloon tamp was used after the stent was released and pressure after ballon dilatation（P>0.05）.  Binary Logistic regression analysis revealed that women and high serum creatinine levels were the independent risk factor for ISR after PCI（P<0.05），and neither red blood cell parameters were independent risk factors for ISR after PCI（P>0.05）. Analysis of ROC curve indicated that the areas under the curve of MCV，MCH，and MCHC for predictive value of ISR after PCI were 0.328，0.276，and 0.385，respectively. Conclusion　Venous red blood cell parameters are associated with the incidence of ISR in patients with coronary heart disease，but are not the independent risk factors for ISR. At the same time，the predictive value of these indicators is limited for ISR.

Key words: Angioplasty, balloon, coronary；In-stent restenosis；Red blood cell parameters；Risk factors