急性心肌梗死高血栓负荷的危险因素分析

Analysis on risk factors of high thrombus formation burden in patients with acute myocardial infartion

目的探讨急性心肌梗死患者梗死相关动脉高血栓负荷的危险因素。方法按照冠脉造影结果将236例急性心肌梗死患者分为高血栓负荷组175例、低血栓负荷组61例。通过观察患者的一般临床情况,检测生化指标、CRP及血浆脑钠肽,将可能的相关因素进行Logistic多因素回归分析。结果 2组患者在性别构成、年龄、高血压、陈旧性心肌梗死、既往血运重建病史、基础心率、血压等方面具有可比性。高血栓负荷组中吸烟患者比例明显高于低血栓负荷组(69.7%vs 45.9%P=0.018),CRP水平(mg/L)显著高于低血栓负荷组(9.31±2.35 vs 7.37±3.89,P=0.038)。将糖尿病、吸烟、白细胞、CRP、D-二聚体(D-dimer)等可能的危险因素进行Logistic回归分析,发现吸烟(OR=2.056,95%CI 1.435～5.160,P=0.024)、CRP(OR=1.379,95%CI 1.048～4.306,P=0.015)是AMI患者高血栓负荷的独立危险因素。结论吸烟、CRP是AMI患者高血栓负荷的独立危险因素。

Objective To explore related factors for high thrombus formation burden of infarct related arteries （IRA） in the acute phase of ST segment elevated myocardial infarction （STEMI） . Methods 236 acute myocardial infarction （AMI） patients treated with primary percutaneous coronary intervention （PCI） were divided into two groups by angiography results obtained during PCI： High thrombus formation burden group（ n = 175） and low thrombus formation burden group（ n =61 ）. Blood samples were collected before PCI for measuring circulating levels of C reactive protein（CRP）, brain natriuretic peptide （BNP）. Logistic analysis was performed. Results Patients in high thrombus formation burden group were significant different from patients in low thrombus formation burden group with smoking （69.5% vs. 45.9%, P = 0.018）, CRP （9.31 mg/L ＋ 2.35 mg/L vs. 7.37 mg/L ＋ 3.89 nag/ L, P =0. 038）. The results of Logistic regression analysis showed that smoking （OR =2. 056, 95% CI 1. 435 -5. 160, P =0. 024）, CRP（OR = 1. 379, 95% CI 1. 048 -4. 306, P =0. 015） are the independent risk factors for AMI patients. Conclusion The levels of smoking and CRP are independent risk factors for high thrombus formation burden in AMI patients.