摘要
目的探讨急性ST段抬高心肌梗死(STEAMI)患者行急诊PCI术中发生无复流的危险因素。方法连续选择因STEAMI住院符合急诊PCI治疗的患者88例,根据是否发生无复流分为正常血流组(n=73)和无复流组(n=15)。采用逐步筛选法选取自变量,多元logistic回归分析STEAMI患者急诊PCI后发生无复流的影响因素。结果 STEAMI患者行急诊PCI后无复流发生率为17.0%。无复流组与正常血流组患者间入院收缩压、合并2型糖尿病比例、肌钙蛋白T峰值、发病-再灌注时间、球囊扩张次数和靶血管置入数量比较,差异有统计学意义(P<0.05)。多因素logistic回归分析显示入院收缩压<100 mmHg(OR=1.019,95%CI:1.006~1.032)、合并2型糖尿病(OR=3.016,95%CI:1.984~3.245)、肌钙蛋白T峰值(OR=1.664,95%CI:1.242~1.845)、发病-再灌注时间(OR=2.988,95%CI:1.545~3.345)、球囊扩张次数(OR=1.864,95%CI:1.545~3.345),是急诊PCI术后无复流发生的独立危险因素(P<0.05)。结论 STEAMI患者行急诊PCI后无复流发生与入院SBP<100 mmHg、合并糖尿病、球囊扩张次数及发病-再灌注时间具有相关性。
Objective To investigate the risk factors of non-reflow during emergency percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation acute myocardial infarction (STEAMI). Methods The patients (n=88) hospitalized due to STEAMI and accorded with emergency PCI were divided into normal group (n=73) and non-reflow group (n=15). The influencing factors of non-flow during emergency PCI were analyzed with multiple Logistic regression analysis after selecting independent variable by using stepwise method. Results The incidence rate of non-flow was 17.0%in STEAMI patients after PCI. The difference in in-hospital systolic blood pressure (SBP), percentage of complicating type 2 diabetes, peak value of cTnT, morbidity-reperfusion time, times of balloon dilatation and number of target vessel implantation had statistical significance between 2 groups (P〈0.05). The multiple Logistic regression analysis showed that in-hospital SBP (〈100 mmHg, OR=1.019, 95%CI:1.006-1.032), complicating type 2 diabetes (OR=3.016, 95%CI:1.984-3.245), peak value of cTnT (OR=1.664, 95%CI:1.242-1.845), morbidity-reperfusion time (OR=2.988, 95%CI:1.545-3.345), and times of balloon dilatation (OR=1.864, 95%CI:1.545-3.345) were independent risk factors of non-slow after emergency PCI (P〈0.05). Conclusion The incidence of non-flow is correlated to in-hospital SBP (〈100 mmHg), complicating type 2 diabetes, times of balloon dilatation and morbidity-reperfusion time in STEAMI patients with non-slow after emergency PCI.
出处
《中国循证心血管医学杂志》
2014年第3期288-290,共3页
Chinese Journal of Evidence-Based Cardiovascular Medicine
关键词
急性ST段抬高心肌梗死
经皮冠状动脉介入术
无复流
ST-segment elevation acute myocardial infarction
Percutaneous coronary intervention
Non-reflow