IMR对NSTEMI患者左心室重塑的相关性分析

Correlation Between IMR and Left Ventricular Remodeling in Patients with NSTEMI

【目的】探讨冠状动脉微循环阻力指数(IMR)对非ST段抬高型心肌梗死(NSTEMI)患者左心室重塑的相关性。【方法】选择2018年1月至2019年1月本院心内科收治的112例NSTEMI患者,根据是患者PCI术后否存在左心室重塑将其分为重塑组(n=23)和非重塑组(n=89)。随访介入术后及出院后12个月,记录两组患者左心室射血分数(LVEF)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV),比较两组患者心功能,分析IMR与心功能的相关性,采用受试者工作特征(ROC)曲线分析IMR识别左心室重塑的临床价值。【结果】出院前,两组患者LVEF、LVEDV及LVESV比较,差异均无统计学意义(P>0.05)。术后12个月,重塑组患者LVEF低于出院前,LVEDV、LVESV显著高于出院前;重塑组患者LVEF显著低于非重塑组,LVEDV显著高于非重塑组,差异均有统计学意义(均P<0.05)。重塑组患者IMR为(38.75±6.31)U,显著高于非重塑组(23.47±4.96)U,差异有统计学意义(P<0.05)。Pearson相关性分析显示,IMR与LVEF呈显著负相关(r=-0.296,P=0.038),与LVEDV及LVESV呈显著正相关(r分别为0.492,0.371,P分别为0.018,0.047)。ROC曲线分析显示,IMR预测NSTEMI患者PCI术后12个月发生左心室重塑价值为(AUC)(95%CI)为0.86(0.79〜0.95)。【结论】IMR是潜在的预测NSTEMI患者预后的指标,临床医师可根据患者IMR及时给予有效治疗措施,对临床改善患者预后具有重要临床意义。

【Objective】To investigate the correlation between coronary microcirculation resistance index(IMR)and left ventricular remodeling in patients with non ST segment elevation myocardial infarction(NSTE-MI).【Methods】A total of 112 patients with NSTEMI treated in the Department of Cardiology of our hospital from January 2018 to January 2019 were-selected.According to whether there was left ventricular remodeling after PCI,they were divided into remodeling group(n=23)and non remodeling group(n=89).12 months after interventional surgery and discharge,the left ventricular ejection fraction(LVEF),left ventricular end diastolic volume(LVEDV)and left ventricular end systolic volume(LVESV)of the two groups were recorded.The cardiac function of the two groups was compared,the correlation between IMR and cardiac function was analyzed,and the clinical value of IMR in identifying left ventricular remodeling was analyzed by receiver operating characteristic(ROC)curye.【Results】Before discharge,there was no significant difference in LVEF,LVEDV and LVESV between the two groups(P>0.05).12 months after operation,LVEF in the remodeling group was lower than that before discharge,and LVEDV and LVESV were significantly higher than that before discharge;LVEF in the remodeling group was significantly lower than that in the non remodeling group,and LVEDV was significantly higher than that in the non remodeling group(all P<0.05).The IMR of patients in remodeling group was(38.75±6.31)U,which was significantly higher.than that in non remodeling group(23.47±4.96)U(P<0.05).Pearson correlation analysis showed that IMR was significantly negatively correlated with LVEF(r=-0.296,P=0.038),and positively correlated with LVEDV and LVESV(r=0.492 and 0.371,P=0.018 and 0.047,respectively).ROC curve analysis showed that the value of IMR in predicting left ventricular remodeling 12 months after PCI in NSTEMI patients was(AUC)(95%CI)0.86(0.79~0.95).【Conclusion】IMR is a potential index to prediet the prognosis of NSTEMI patients.Clinicians can give effeetive treatment measures in time according to IMR,which is of great clinical significance to improve the prognosis of patients.