ST段抬高型心肌梗死患者经皮冠状动脉介入后冠脉微循环损伤的状况分析

Coronary Microcirculation Injury in Patients with ST Segment Elevation Myocardial Infarction After Percutaneous Coronary Intervention

目的探讨ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入(PCI)后冠脉微循环损伤的状况,并分析可能的影响因素。方法选取2018年4月至2021年4月郑州人民医院收治的100例STEMI患者为研究对象,患者均接受PCI治疗,术后2 h内检测冠脉微循环阻力指数(IMR),根据测量结果评估患者冠脉微循环损伤发生情况,并归为发生组与未发生组;记录患者基线资料及相关实验室指标,分析STEMI患者PCI后发生冠脉微循环损伤的影响因素。结果100例STEMI患者PCI后发生冠脉微循环损伤32例,占32.00%。发生组糖化血红蛋白(HbA1c)、D-二聚体(D-D)水平高于未发生组,预扩张时间长于未发生组,差异有统计学意义(P<0.05)。两组其他基线资料比较,差异无统计学意义(P>0.05)。多因素logistic回归分析结果显示,HbA1c、D-D高表达及预扩张时间较长是STEMI患者PCI后发生冠脉微循环损伤的影响因素(OR>1,P<0.05)。结论HbA1c、D-D高表达及预扩张时间较长是STEMI患者PCI后发生冠脉微循环损伤的影响因素。

Objective To investigate the injury of coronary microcirculation in patients with ST segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI),and to analyze its possible influencing factors.Methods A total of 100 patients with STEMI admitted to Zhengzhou People’s Hospital from April 2018 to April 2021 were selected as the research subjects,and all patients received PCI treatment.The coronary microcirculation resistance index(IMR)of patients was measured within 2 hours after operation.According to the measurement results,the occurrence of coronary microcirculation injury of patients was evaluated and the patients were divided into the occurrence group and the non occurrence group.The baseline data and laboratory parameters of patients were asked and recorded,the influencing factors of coronary microcirculation injury in STEMI patients after PCI were analyzed.Results Among 100 STEMI patients after PCI,32 cases had coronary microcirculation injury,accounting for 32.00%.Glycosylated hemoglobin(HbA1 c)and D-Dimer(D-D)levels of the occurrence group were higher than those of the non occurrence group,and the pre-dilation time was longer than that of the non occurrence group,and the differences were statistically significant(P<0.05).There was no statistical significant difference in other baseline data between the two groups(P>0.05).The results of multivariate logistic regression analysis showed that high expression of HbA1 c and D-D and long pre-dilation time might be the influencing factors of coronary microcirculation injury in STEMI patients after PCI(OR>1,P<0.05).Conclusion High expression of HbA1 c and D-D and long pre-dilation time may be the influencing factors of coronary microcirculation injury in STEMI patients after PCI.