急性心肌梗死患者经皮冠状动脉介入治疗术后ST段回落不良的分析

Analysis of imperfect ST-segment resolution in acute myocardial infarction patients after percutaneous coronary intervention

目的探讨ST段抬高急性心肌梗死(AMI)患者直接PCI术后ST段回落不良的相关因素。方法173例符合ST段抬高AMI诊断并行直接PCI的患者,计算其心电图ST段回落指数,运用logistic回归分析影响ST段回落的相关因素。结果冠状动脉造影心肌呈色分级0/1(OR=2.936)、病变部位(OR=2.121)、胸痛开始到再灌注的时间(OR=1.314)、梗死前心绞痛(OR=1.053)是影响术后心电图ST段恢复的相关因素。结论AMI直接PCI术后心电图ST段恢复程度与上述因素有关。

Objective To investigate the relative factors of imperfect ST-segment resolution in STEMI patients after successful PCI. Methods 173 STEMI patients received successful PCI and their ST-segment elevation resolution was evaluated. Multivariate logistic analysis was used to identify relative factors influencing ST-segment resolution of STEMI patients treated with PCI. Results Univariate analysis showed that diabetes mellitus, the time from symptom onset to reflow, pre-infarctlon agina, Killip class, number of Q waves, infarction relative artery, myocardial blush grade（MBG） and LDL-C were related to ST-segment resolution. Multivariate logistic analysis indicated that MBG 0/1 （OR = 2. 936） ,infarction relative artery （OR = 2. 121）, the time from symptom onset to reflow （OR = 1. 314）, pre-infarction agina （OR = 1. 053）were related to ST-segment resolution. Conclusions The above factors may play a role in ST-segment resolution in STEMI patients treated with PCI.