急性心肌梗死介入术后发生心肌缺血/再灌注损伤的危险因素分析

Risk Factors of Postoperative Myocardial Ischemia and Reperfusion Injury in Acute Myocardial Infarction Treated with Intervention Operation

目的研究分析急性心肌梗死(AMI)介入术后发生心肌缺血/再灌注损伤(MIRI)的危险因素。方法选择本院2009年6月至2010年12月184例接受经皮冠状动脉介入术且手术成功的AMI患者的临床资料,采用多因素Logistic回归模型分析MIRI的危险因素。结果 MIRI出现的危险因素包括AMI发病时间≤6 h、下壁梗死、多支血管病变,其中发病时间≤6 h(P=0.021)、下壁梗死(P=0.007)是独立性危险因素,多支血管病变(P=0.056)是危险因素。梗死前的心绞痛(P=0.004)起到保护作用,是独立性保护因素。结论临床上发病时间短、下壁梗死、多支血管病变的AMI患者冠状动脉介入治疗后发生MIRI的危险性较高,而心肌梗死前有心绞痛对MIRI有保护作用,临床对该类患者应引起重视,注意预防。

Objective To study the risk factors of postoperative myocardial ischemia and reperfusion injury（MIRI）in acute myocardial infarction treated with intervention operation.Methods 184 cases of acute myocardial infarction（AMI）patients treated with percutaneous coronary intervention（PCI）in our hospital from June 2009 to December 2010 were chosen to research myocardial ischemia and reperfusion injury risk factors with multivariate logistic regression model.Results The risk factors of MIRI included the AMI onset time ≤6 h,the inferior wall infarction,multivessel disease,of which,time of onset ≤6 h（P=0.021）,inferior wall infarction（P=0.007）were independent risk factors multi-vessel disease（P=0.056）was a risk factor.Pre-infarction angina（P=0.004）has protective effects,it was an independent protective factor.Conclusion The risk of heart ischemia and reperfusion injury in AMI patients with the short clinical onset time,inferior wall infarction,multivessel disease is high,while angina before myocardial infarction has a protective effect,the patients should be concerned for prevention purpose.