血清降钙素原与急性心肌梗死患者直接经皮冠状动脉介入治疗无复流的关系

The association of serum procalcitonin with no-reflow phenomenon during primary percutaneous coronary intervention in patients with acute myocardial infarction

目的探讨血清降钙素原（PCT）水平与急性心肌梗死患者直接经皮冠状动脉介入治疗（PCI）中发生无复流的关系。方法直接PCI治疗的急性心肌梗死患者360例，根据PCI术中无复流发生情况分为无复流组和再灌注组，比较两组患者的年龄、糖尿病史、Syntax评分、发生症状至球囊扩张时间、血白细胞计数、血清降钙素原（PCT）、超敏C反应蛋白（hs-CRP），采用logistic多因素回归分析筛选急性心肌梗死患者直接PCI术中无复流的相关因素。结果无复流组的年龄、糖尿病比例、白细胞计数、PCT、hs-CRP[（67.3±16.3）岁、37.2%、（11.7±3.8）109/L、（0.102±0.547）ng/ml、（38.6±6.21）mg/L]均高于再灌注组[（59.8±14.9）岁、26.2%（10.8±3.6）109/L、（0.042±0.026）ng/ml、（16.9±5.35）mg/L]，差异均有统计学意义（均P＜0.05）。无复流组Syntax评分[（24.7±9.1）分]高于再灌注组[（15.6±8.9）分]，发生症状至球囊扩张时间[（357.4±189.7）min]长于再灌注组[（298.5±122.1）min]，差异均有统计学意义（均P＜0.05）。PCT、发生症状至球囊扩张时间与直接PCI术中冠状动脉无复流有关（均P＜0.05）。结论血清PCT增高与急性心肌梗死直接PCI术中冠状动脉无复流发生相关。

Objective To assess the association of serum procalcitonin (PCT) level with no-reflow phenomenonduring primary percutaneous coronary intervention(PCI) in patients with acute myocardial infarction(AMI). Methods 360consecutive patients with AMI who underwent primary PCI were enrolled. They were divided into no-reflow group andreflow group. Age, diabetic history, Syntax score, the time interval from symptom onset to balloon, white blood cell count,serum PCT and hs-CRP were compared between the two groups. Multivariate logistic regression analysis was performedto determine the factors influencing no-reflow during primary PCI. Results Age,the percentage of diabetes,white bloodcell count,serum PCT,hs-CRP levels, Syntax score as well as the time interval from symptom onset to balloon weresignificantly higher in no-reflow group than in reflow group (all P<0.05). PCT and the time interval from symptom onset toballoon were significantly correlated with no-reflow during primary PCI of AMI (all P<0.05). Conclusion The elevatedserumPCT is associated with coronary no-reflow during primary PCI of AMI.