摘要
目的探讨D-二聚体水平与老年急性ST段抬高型心肌梗死(ST-elevated myocardiol infarction,STEMI)患者直接PCI后无复流的关系。方法连续性入选老年急性STEMI接受直接PCI患者124例,根据术后即刻血流TIMI分级和心肌染色分级将患者分为正常血流组84例和无复流组40例。比较2组D-二聚体水平,并探讨D-二聚体水平与术后无复流发生的关系。结果无复流组患者D-二聚体水平明显高于正常血流组[0.91(0.55,1.41)mg/L vs 0.46(0.33,0.96)mg/L,P=0.00]。多元logistic回归分析显示,D-二聚体水平是介入术后无复流发生的独立危险因素(OR=4.18,95%CI:1.18~14.7,P=0.026)。ROC曲线分析显示,术前D-二聚体界值为0.74mg/L时,预测术后无复流发生的敏感性为70.0%,特异性为72.6%。血浆D-二聚体>0.74mg/L患者的无复流发生率明显高于血浆D-二聚体≤0.74mg/L患者无复流发生率(54.0%vs 17.5%,P=0.00)。结论老年急性STEMI患者接受直接PCI后,冠状动脉无复流发生与D-二聚体水平相关。
Objective To study the relationship between plasma D-dimer level and no-reflow in elderly acute STEMI patients after primary PCI.Methods One hundred and twenty-four elderly acute STEMI patients who underwent primary PCI were divided into reflow group(n=84)and no-reflow group(n=40)according to their immediate TIMI flow grade.The relationship between plasma D-dimer level and no-reflow in elderly acute STEMI patients was analyzed after primary PCI.Results The plasma D-dimer level was significantly higher in no reflow group than in reflow group[0.91(0.55,1.41)mg/L vs 0.46(0.33,0.96)mg/L,P=0.00].Multivariate logistic regression analysis showed that plasma D-dimer level was an independent risk factor for no-reflow in elderly acute STEMI patients after primary PCI(OR=4.18,95%CI:1.18-14.7,P=0.026).ROC curve analysis revealed that the preoperative plasma D-dimer level could predict no reflow in elderly acute STEMI patients when its cutoff was 0.74 mg/L with a sensitivity of 70%and a specificity of 72.6%.The incidence of no-reflow was significantly higher when the planma D-dimer level was〉0.74 mg/L than when the planma D-dimer level was≤0.74 mg/L in elderly acute STEMI patients(54.0%vs 17.5%,P=0.00).Conclusion No-reflow in coronary artery is related with plasma D-dimer level in elderly acute STEMI patients after primary PCI.
作者
胡铂
康晟
赵小红
王小东
周华
张奇
Hu Bo;Kang Sheng;Zhao Xiaohong;Wang Xiaodong;Zhou Hua;Zhang Qi(Department of Cardiology,Affilated Hospital of Tongji Universit)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2018年第10期1037-1040,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
上海市浦东新区卫生和计划生育系统学科建设计划(PWZxq2017-05)