影响急性冠脉综合征经皮冠状动脉成形术后慢血流-无复流的相关因素

Related factors of slow coronary flow-no reflow after percutaneous coronary angioplasty for acute coronary syndrome

目的分析急性冠脉综合征经皮冠状动脉成形术(PCI)术后慢血流-无复流(SCF/NR)的相关影响因素。方法选取行PCI术急性ST段抬高性心肌梗死(STEMI)患者共152例,根据PCI后TIMI血流分级分为SCF/NR组和正常血流组,分析两组患者PCI术后慢血流-无复流的相关影响因素。结果两组性别、BMI、高血压史、家族史、吸烟、饮酒、术前TIMl血流分级、killip分级、尿潜血、左心室舒收末内径、梗死相关动脉、病变位置、弥漫程度、介入治疗方法、射血分数、白细胞计数(WBC)、天门冬氨酸氨基转移酶(AST)、总胆固醇(TC)、三酰甘油(TG)、载脂蛋白A(ApoAI)、载脂蛋白B(ApoB),高密度脂蛋白胆固醇(HDL-C)、脂蛋白a(LPa)、血清胱抑素C(Cys-c)、K+、凝血酶原时间(PT)、国际标准化比值(INR)、活化部分凝血酶原时间(APTT)、D-2聚体(D-D)、病变血管支数、病变血管长度、病变血管直径、支架数量比较无统计学意义(P>0.05);SCF/NR组年龄、糖尿病、低密度脂蛋白胆固醇(LDL-C)、发病至血管开通时间比较高于无SCF/NR组(P<0.05)。多元Logistic回归分析显示,年龄、LDL-C、发病至血管开通时间是术后出现SCF/NR的独立危险因素。结论年龄、LDL-C、发病至血管开通时间是急性冠脉综合征经PCI术后出现SCF/NR的独立危险因素。

Objective To analyze the related factors of slow coronary flow-no reflow(SCF/NR)after percutaneous coronary intervention(PCI)for acute coronary syndrome.Methods Totally 152 patients with acute ST-segment elevation myocardial infarction(STEMI)undergoing PCI were selected.According to TIMI flow grades after PCI,they were divided into SCF/NR group and normal flow group.The related influencing factors of SCF/NF in two groups patients were analyzed after PCI.Results There were no statistically significant differences between two groups in sex,BMI,hypertension history,family history,smoking,drinking,preoperative TIMl flow grades,killip grades,occult blood in urine,left ventricular end systolic diameter,infarct-related artery,lesion location,diffuse degree,interventional therapy method,ejection fraction,WBC,AST,TC,TG,HDL-C,LPa,Cys-c,K+,PT,INR,APTT,D-D,number of lesion vessels,length of lesion vessels,diameter of lesion vessels and stent number(P>0.05).Compared with patients in non-SCF/NF group,Gender in SCF/NF group were older and had higher incidence of diabetes mellitus,higher LDL-C,and longer time from onset to vascular patency(P<0.05).Multivariate Logistic regression analysis showed that age,LDL-C,time from onset to vascular patency were independent risk factors for SCF/NR after surgery.Conclusion Age,LDL-C,time from onset to vascular patency are independent risk factors for SCF/NR in acute coronary syndrome after PCI.