急性ST段抬高型心肌梗死患者急诊PCI术后无复流相关因素分析

Analysis of Related Factors of No Reflow in Patients with Acute ST Segment Elevation Myocardial Infarction after Emergency Percutaneous Coronary Intervention

探讨急性ST段抬高型心肌梗死患者急诊PCI术后发生无复流的相关因素。2015年1月~2017年11月在我院因急性ST段抬高型心肌梗死接受急诊PCI手术的患者453名,根据TIMI血流分级和MBG分级标准将患者分为正常血流组和无复流组,比较这两组患者基本临床资料、造影结果和手术相关资料的差异。通过单变量分析,症状至PCI时间、血糖、Killip分级、干预前血流TIMI分级、血栓负荷程度、病灶血管长度与急诊PCI术后发生无复流有关(P<0.05),通过二分类Logistic回归分析,确定症状至PCI时间(OR:1.20;95%CI:0.90~1.54)、血糖(OR:1.08;95%CI:1.03~1.39)、干预前血流TIMI分级(OR:0.92;95%CI:0.79~1.07)、血栓负荷程度(OR:1.40;95%CI:0.96~1.87)、病灶血管长度(OR:1.18;95%CI:1.02~1.37)是急诊PCI术后发生无复流的独立预测因素。

To investigate the related factors of no reflow in patients with acute ST segment elevation myocardial infarction（STEMI）after emergency percutaneous coronary intervention（PCI）.A total of 453 patients underwent emergency PCI surgery in our hospital for acute STEMI from January 2015 to November 2017,the patients were divided into normal blood flow and no reflow group according to the TIMI blood flow classification and MBG grading standard.The differences of basic clinical data,the results of angiography and the operation related data were compared between two groups.Through the univariate analysis,the symptoms to PCI time,blood sugar,Killip classification,blood flow TIMI classification before intervention,the degree of thrombus load,and the length of the lesion vascular were related to no reflow after the emergency PCI operation（P〈0.05）,by two classified Logistic regression analysis,the symptom to PCI time（OR：1.20;95%CI：0.90~1.54）,blood glucose（OR：1.08;95%CI：1.03~1.39）,blood flow TIMI classification before intervention（OR：0.92;95%CI：0.79~1.07）,thrombus load degree（OR：1.40;95%CI：0.96~1.87）,and the length of the lesion vessel（OR：1.18;95%CI：1.02~1.37）were independent predictors of no reflow after emergency PCI in AMI patients.