摘要
目的:探讨急性ST段抬高型心肌梗死(STEMI)患者C反应蛋白(CRP)、血小板平均容积(MPV)水平与直接经皮冠脉介入治疗(PCI)术中无复流(NR)发生的关系。方法:回顾性分析2015年1月至2016年12月156例STEMI患者行直接PCI的临床和影像资料。根据术中是否发生NR,患者被分为NR组(54例)和无NR对照组(102例)。多因素Logistic回归分析NR发生的影响因素。结果:与无NR对照组比较,NR组糖尿病比例(23.5%比42.6%)、CRP[(31.7±5.3)mg/L比(64.5±9.7)mg/L]和MPV水平[(9.31±1.05)fl比(11.29±0.98)fl]均显著升高,支架数[(1.9±0.4)枚比(2.1±0.6)枚]显著增多,症状至球囊扩张时间[(254±96)min比(315±108)min]显著延长,P<0.05或<0.01。多因素Logistic回归分析显示,糖尿病、症状至球囊扩张时间、CRP、MPV水平是NR发生的独立危险因素(OR=2.335~3.670,P<0.05或<0.01)。结论:C反应蛋白、血小板平均容积升高是STEMI患者直接PCI术中发生无复流的独立危险因素,对于无复流的发生具有一定的预测价值,值得推广。
Objective:To explore relationship among levels of C reactive protein(CRP),mean platelet volume(MPV)and occurrence of no-reflow(NR)during primary percutaneous coronary intervention(PCI)in patients with acute ST elevation myocardial infarction(STEMI).Methods:Clinical and imaging data of 156 STEMI patients,who received primary PCI from Jan 2015 to Dec 2016,were retrospectively analyzed.According to presence of NR during PCI,patients were divided into NR group(n=54)and no NR control group(n=102).Multi-factor Logistic regression analysis was used to analyze influencing factors of NR occurrence.Results:Compared with no NR control group,there were significant rise in percentage of diabetes mellitus(23.5% vs.42.6%),levels of CRP[(31.7±5.3)mg/Lvs.(64.5±9.7)mg/L]and MPV [(9.31±1.05)fl vs.(11.29±0.98)fl],number of stents[(1.9±0.4)vs.(2.1±0.6)]and symptom-onset-to-balloon[SOTB,(254±96)min vs.(315±108)min]in NR group,P〈0.05 or0.01.Multi-factor Logistic regression analysis indicated that diabetes mellitus,SOTB,levels of CRP and MPV were independent risk factors for NR occurrence(OR=2.335~3.670,P〈0.05 or0.01).Conclusion:Rise of CRP and MPV levels are independent risk factors for no-reflow during primary PCI in STEMI patients,which possess certain predictive value for no-reflow occurrence and worth extending.
作者
黄开建
林德奇
林茂海
HUANG Kai-jian; LIN De-qi; LIN Mao-hai(Department of Cardiology, First Hospital of Putian City, Putian, Fujian, 351100, China)
出处
《心血管康复医学杂志》
CAS
2018年第5期520-523,共4页
Chinese Journal of Cardiovascular Rehabilitation Medicine
关键词
心肌梗死
无复流现象
血管成形术
气囊
冠状动脉
Myocardial infarction
No-reflow phenomenon
Angioplasty
balloon
coronary