摘要
目的分析急性心肌梗死(acute myocardial infarction, AMI)患者行经皮冠状动脉(冠脉)介入治疗(percutaneous coronary intervention, PCI)术后无复流现象的影响因素。方法选取2015年1月—2017年6月收治的行PCI治疗的AMI 312例,根据有无复流及TIMI等级,分为无复流组(TIMI 0～1级,n=37)与复流组(TIMI 3级,n=275)。记录胸痛持续时间、冠心病危险因素,检测入院时外周血相关指标及心电图ST段改变,观察PCI相关影像学变化及TIMI血流情况,评估左室功能、血栓等级、血管痉挛等变化,分析无复流影响因素。结果两组血白细胞计数、高敏C-反应蛋白、胸痛持续时间、最大ST段变化、左室射血分数、血栓等级、分叉病变、偏心病变、累及血管数、血管痉挛等级比较差异均有统计学意义(P<0.05)。多因素logistic回归分析显示,血白细胞计数、血栓等级、血管痉挛等级是预测PCI术后无复流现象的独立因素(P<0.05)。结论血白细胞计数、血栓分级、血管痉挛等级是预测AMI PCI术后无复流现象的独立因素。
Objective To evaluate the influencing factors of no-reflow phenomenon after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction(AMI). Methods A total of 312 AMI patients who underwent PCI from January 2015 to June 2017 were enrolled in this study.They were divided into no-reflow after PCI group (TIMI grade 0-1, n =37)and normal reflow after PCI group (TIMI grade 3, n =275)according to presence or absence of reflow and TIMI grade.The duration of chest pain and the risk factors of coronary heart disease were recorded. Indexes of peripheral blood and ST-segment changes of ECG were detected at admission. The changes of PCI-related imaging and TIMI blood flow were observed. The changes of left ventricular function, thrombus grade and vasospasm were evaluated. The influencing factors of no-reflow were analyzed. Results There were significant differences in white blood cell (WBC) count, high sensitive C-reactive protein, duration of chest pain, changes of maximum ST segment, left ventricular ejection fraction, thrombus grade, bifurcation lesion, eccentric lesion, number of involved vessels and degree of vasospasm between the two groups ( P <0.05).Multivariate logistic regression analysis showed that WBC count, thrombus grade and vasospasm grade were independent predictors of no-reflow phenomenon after PCI ( P <0.05). Conclusion WBC count, thrombosis grade, and vasospasm grade are independent predictors of no-reflow phenomenon in patients with AMI after PCI.
作者
刘朝晖
李德才
刘思泰
袁明
LIU Zhao-hui;LI De-cai;LIU Si-tai;YUAN Ming(Department of Cardiology, Fifth People's Hospital of Chengdu, Chengdu 611130, China;Department of Cardiology, Sichuan Mianyang 404 Hospital, Mianyang, Sichuan 621000, China)
出处
《临床误诊误治》
2019年第3期85-89,共5页
Clinical Misdiagnosis & Mistherapy
基金
四川省卫生厅科研基金资助项目(140325)
关键词
急性心肌梗死
经皮冠状动脉介入治疗
无复流现象
Acute myocardial infarction
Percutaneous coronary intervention
No-reflow phenomenon
