稳定性心绞痛老年患者经皮冠脉介入治疗后发生微循环障碍的相关因素分析

Related factors about microcirulatory injury following elective PCI for elder patients with stable angina

目的:探究稳定性心绞痛老年患者经皮冠脉介入治疗后出现微循环障碍的相关因素。方法:选取我院2009年2月至2014年2月期间接受经皮冠脉介入治疗(PCI)的稳定型心绞痛老年患者72例,记录患者临床资料,并计算微循环阻力指数(IMR)。对患者的一般临床资料与PCI术前及术后IMR值进行相关性分析,并通过回归分析得出PCI术后发生微循环障碍的相关因素。结果:患者经PCI治疗后,FFR、CFR、CK-MB、肌钙蛋白等值均高于治疗前(P<0.05)。直线回归分析显示,糖化血红蛋白、血管狭窄程度与PCI术后IMR值呈正相关,射血分数、PCI术前CFR与术后IMR值呈负相关。结论 :临床上,糖尿病患者、血管狭窄程度严重、射血分数低及PCI术前CFR低的稳定性心绞痛患者可能在PCI术后容易发生微循环障碍。

Objective To investigate microvascular injury-related factors post-percutaneous coronary intervention （PCI）. Methods Seventy-two elderly patients with stable angina , who underwent PCI from February 2009 to February 2014, were enrolled in this study. The index of microvascular resistance （IMR） was assessed and the clinical data were collected. The correlation between general clinical data and the IMR value before and after PCI were analyzed, and regression analysis was conducted on the relevant factors with postoperative microcirculation after PCI. Results After PCI, FFR, CFR, CK-MB, troponin were higher than those before PCI, with significant differences （P 〈 0.05）. Linear regression analysis result showed that glycated hemoglobin, the degree of stenosis after PCI were positively correlated with IMR, but ejection fraction and CFR before PCI were negatively correlated with IMR. Conclusion Clinically, diabetes, severe vascular stenosis, low ejection fraction, low CFR before PCI in patients with unstable angina may likely occur microcirculation after PCI.