摘要
目的分析术前氧化应激水平与急性心肌梗死(acute myocardial infarction,AMI)患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后再灌注心律失常(reperfusion arrhythmia,RA)的相关性。方法回顾性选取2022年5月至2024年5月阜外华中心血管病医院心内科收治的行PCI的AMI患者120例,依据RA发生情况分为RA组46例和非RA组74例。收集所有患者一般临床资料。采用多因素logistic回归分析筛选AMI患者在PCI术后RA发生的影响因素,用ROC曲线分析术前氧化应激水平对PCI术后RA发生的预测价值。结果RA组发病至PCI<6 h、下壁梗死、病变血管心肌梗死溶栓试验(thrombolysis in myocardial infarction,TIMI)分级0级比例明显高于非RA组,差异有统计学意义(P<0.01)。RA组术前丙二醛水平明显高于非RA组高,术前SOD水平明显低于非RA组,差异有统计学意义(P<0.01)。多因素logistic回归分析显示,病变血管TIMI分级0级(OR=3.484,95%CI:1.043~11.633,P=0.042)、发病至PCI<6 h(OR=4.143,95%CI:1.227~13.989,P=0.022)、下壁梗死(OR=54.265,95%CI:2.0271450.950,P=0.017)、术前丙二醛(OR=2.495,95%CI:1.570~3.966,P=0.001)是AMI患者PCI术后发生RA的危险因素;术前SOD(OR=0.823,95%CI:0.749~0.905,P=0.001)是AMI患者PCI术后RA发生的保护因素。ROC曲线分析显示,术前丙二醛、术前SOD预测AMI患者PCI术后RA发生的曲线下面积分别为0.809、0.849(P<0.001)。结论病变血管血流TIMI分级0级、发病至PCI<6 h、下壁梗死、术前丙二醛及术前SOD均是AMI患者PCI术后RA发生的影响因素,且术前丙二醛、术前SOD水平可有效预测PCI术后RA发生风险。
Objective To analyze the correlation between preoperative oxidative stress levels and reperfusion arrhythmia(RA)in post-PCI patients with acute myocardial infarction(AMI).Methods A total of 120 AMI patients undergoing PCI in our hospital from May 2022 to May 2024 were recruited,and according to the occurrence of RA,they were divided into a RA group(46 cases)and a non-RA group(74 cases).The general clinical data were collected in all patients.Multivariate logistic regression was used to screen the influencing factors for the occurrence of RA after PCI in AMI patients.ROC curve analysis was applied to determine the predictive value of the preoperative oxidative stress levels for the occurrence of RA after PCI.Results The RA group had significantly larger proportions of onset-to-PCI time<6 h,inferior wall infarction,and culprit vessel at thrombolysis in myocardial infarction(TIMI)grade O than the non-RA group(P<0.01).The preoperative level of malondialdehyde(MDA)was obviously higher,while that of superoxide dismutase(SOD)was notably lower in the RA group than the non-RA group(P<O.O1).Multivariate logistic regression analysis showed that culprit vessel at TIMI grade O(OR=3.484,95%CI:1.043-11.633,P=0.042),0nset-to-PCI time<6 h(OR=4.143,95%CI:1.227-13.989,P=0.022),inferior wall infarction(OR=54.265,95%CI:2.027-1450.950,P=0.017),and preoperative MDA(OR=2.495,95%CI:1.570-3.966,P=0.001)were risk factors for RA after PCI in AMI patients;preoperative SOD(OR=0.823,95%CI:0.749-0.905,P=0.001)was a protective factor.ROC curve analysis indicated that the AUC value of preoperative MDA and preoperative SOD in predicting RA after PCI in AMI patients was 0.809 and 0.849,respectively(P<0.001).Conclusion Culprit vessel at TIMI grade O,onset-to-PCI time<6 h,inferior wall infarction,and preoperative MDA and SOD are all influencing factors for RA in post-PCI AMI patients.Moreover,preoperative MDA and SOD levels can effectively predict the risk of RA after PCI in the patients.
作者
吴慧颖
邵芳
邢文露
刘洋
Wu Huiying;Shao Fang;Xing Wenlu;Liu Yang(Department of Cardiology,Fuwai Central China Cardiovascular Hospital,Zhengzhou 451464,Henan Province,China)
出处
《中华老年心脑血管病杂志》
北大核心
2025年第10期1317-1321,共5页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
河南省医学科技攻关计划项目(LHGJ20240155)。
