脱氢表雄酮对急诊冠状动脉介入术中慢血流-无复流现象的预测价值

PredictiveValue of Dehydroepiandrosterone for Slow-No-Reflow Phenomenon during Primary Percutaneous Coronary Intervention

目的评估以血浆脱氢表雄酮(DHEA)含量预测急性心肌梗死(AMI)患者急诊冠状动脉介入手术(PCI)术中出现慢血流-无复流风险的价值。方法选取因AMI来我院并行急诊PCI治疗并且术中出现慢血流-无复流的患者56例,选取同期行急诊PCI且术中冠脉血流正常的对照组患者56例。术前常规采集静脉血,检测血浆DHEA浓度,比较两组间DHEA有无差异;应用ROC曲线分析DHEA对慢血流-无复流现象的预测价值。结果1.两组间血浆DHEA水平存在显著差异;2.应用ROC曲线分析DHEA水平对慢血流-无复流的预测价值,曲线下面积0.859(95%可信区间0.790-0.929,P<0.01)。当截点值为325 ug/dl时,术前血浆DHEA水平对PCI术中慢血流-无复流进行预测的特异性与敏感性分别为82.1%及76.8%。结论血浆DHEA水平是AMI患者急诊PCI术中慢血流-无复流的预测因素,并具有较好的特异性和敏感性。

Objective To analyze the predictive value of dehydroepiandrosterone(DHEA)on slow-noreflow phenomenon in patients with acute myocardial infarction(AMI)during primary percutaneous coronary intervention(PCI).Methods 56 patients with AMI underwent emergency PCI and slow-no-reflow during operation were selected.56 patients were selected as control group who underwent emergency PCI and had normal coronary blood flow.The factors associated with slow-no-reflow were collected and analyzed.ROC curve was used to identify predictive value of DHEA on slow-no-reflow phenomenon.Results 1.There were significant differences in plasma DHEA levels between the two groups;2.The area under the ROC curve for ratio was 0.859(95%CI 0.790-0.929,P<0.01).At a cut-off point of 325 ug/dl,the value of DHEA exhibited 82.1%in specificity and 76.8%in sensitivity for detecting slow-no-reflow phenomenon during PCI.Conclusion The value of DHEA can predict slow-no-reflow phenomenon in AMI patients undergoing PCI,with high sensitivity and specificity.