| The Background and purpose The coronary heart disease has already become the most common death reason in the world, the incidence of the disease in our country becomes the ascendant trend year by year . Since Gruentzig launched PTC A in 1977, there is a more kind of means to the treatment of the coronary heart disease. The implant of stent in coronary artery has already greatly improved the curative effect early and long-term than the skill of PTCA. It is anticoagulation plus stent to reduce the rate of acute obstruction after the surgeon, especially very helpful to the acute high-risk group of acute vessel closure, at the same time,it expands the adaptation card of the implant of stent. However, restenosis rate is still 10%-58% in different characteristic lesion and the subgroup patients in which who had accepted the implant of stent. this has restrained involvement of the coronary heart disease patient from treating~[1]At present, the pathophysiological course of in-stent restenosis has notknown clearly to make the affective cause clear is to help to find out complicated pathophysiological mechanism of the course. A lot of clinical testing evaluate in-stent restenosis from clinic, characteristic of coronary artery lesion and operating factor, it is thought that operating facter and blood vessel repaired response lead by damage induced by the implant of stent are the main michanics of in-stent restenosis. The main mechanism of restenosis of PTCA is the reshape and elastic contract after the skill only, and it has been proved by ultrasound that hyperplasia in endothelium in the blood vessles is the only mechanic of restenosis in-stent. So to understand dangerous factors of in-stent resdenosis contributes to judging the adaptation card in implanting it, raising the operating technology and preventing in-stent restenosis. For this reason, we study and research the affective factor though 43 cases who have accepted the second coronary artery angiography in our hospital from 2000-3-2004-11 by the method of QCA.Methods 43 patients who were implanted stent in coronary artery and reangiographied in our hospital from 2000-3-2004-11 were selected in our investigation. There were 20 cases in in-stent restenosis group and 23 cases in without-restenosis group. There were 49 lesions which had been dealt with and 52 stents had been implanted in them. The average time of follow-up was (679± 330.9 days). All cases were divided into two groups accoding to the result of angiography if there was restenosis. The definition of restenosis is the extent of restenosis in stent 50%, it was thought in-stent restenosis if the edge of restenosis is within 5mm outside from the stent. The reference vessles are the normal blood vessel farside the lesion. The radiography machine is VOC digital subtraction angiograghy (DSA) from GE company in American. The operation method was the method of Seldinger's puncture though right femoral artery. The ill vessels were photographed by left anterior obliqueand cranial, right anterior oblique and cranial, right anterior oblique and caudal, post-anterior and cranial, post-anterior and caudal, left and laterral ,right and latral position. According to dividing the case into restenosis group (n=20) and without restenosis group (n=23), Then compared dangerous factors , characteristic of lesions of two groups , analysed the data with software of SPSS 10.0. The data of numerical variable were analysed with t-test, the data of catagorical variable were analysed withx 2 test, p<0.05 has significant differences for statistics.Results There was no significant difference in age, in risk factor including (high lipidemia, high blood pressure, diabetes), but in sex , in smoke two groups had significant differences, The extent of restenosis in lesion between two groups had significant difference, but there was no significant difference including in the numbers of the lesion, in position of the lesion, the type of the lesion, There was significant difference in the type of stent between two groups. There was no difference between the length of stent, the diameter of stent and the category of coronary artery disease while admitted to hospital before operation.Conclusions Multiple factors are analysed to indicate: Smoking and narrow extent of coronary artery lesion are the risk factors of in-stent restenosis(p <0.05). Drug-eluting stent which has been planted in coronary artery is protective factors of in-stent restenosis.
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