老年急性冠状动脉综合征患者PCI术后发生冠状动脉慢血流/无复流的影响因素

Influencing factors of coronary slow flow/no-reflow after PCI in elderly patients with acute coronary syndrome

目的:分析老年急性冠状动脉综合征(ACS)患者经皮冠状动脉介入(PCI)术后发生冠状动脉慢血流/无复流的影响因素。方法:选取2019年2月至2021年12月284例行PCI术的老年ACS患者进行横断面研究,根据术后冠状动脉TIMI分级分为正常血流组(n=186)和慢血流/无复流组(n=98)。比较两组临床资料,采用多因素Logistic回归分析老年ACS患者PCI术后冠状动脉慢血流/无复流的影响因素。结果:慢血流/无复流组PSQI评分>7分占比、预扩张支架术占比、支架数目、支架长度、血清补体1q(C1q)水平、血清S100钙结合蛋白B(S100B)水平、血清红细胞膜总胆固醇(CEM)水平均高于正常血流组,差异有统计学意义(P<0.05);Logistic回归分析结果显示,PSQI评分>7分、支架置入方式为预扩张支架术、支架数目≥2个、支架长度>18.20 mm、C1q水平>179.51μg/mL、S100B水平>94.46 pg/mL、CEM水平>111.51 mg/g均为老年ACS患者PCI术后发生冠状动脉慢血流/无复流的危险因素(OR>1,P<0.05)。结论:PSQI评分>7分、支架置入方式为预扩张支架术、支架数目≥2个、支架长度>18.20 mm、C1q水平>179.51μg/mL、S100B水平>94.46 pg/mL、CEM水平>111.51 mg/g均为老年ACS患者PCI术后发生冠状动脉慢血流/无复流的危险因素。

Objective:To analyze influencing factors of coronary slow flow/no-reflow after percutaneous coronary intervention(PCI)in elderly patients with acute coronary syndrome(ACS).Methods:A cross-sectional study was conducted on 284 elderly ACS patients who underwent PCI from February 2019 to December 2021.These patients were divided into normal flow group(n=186)and slow flow/no-reflow group(n=98)according to the postoperative TIMI grade of coronary artery.The clinical data of the two groups were compared.Multivariate logistic regression was used to analyze the influencing factors of coronary slow flow/no-reflow after PCI in the elderly ACS patients.Results:The proportion of PSQI score>7 points,the proportion of pre-expanded stent implantation,the number of stents,the length of stents,the level of serum C1q,the level of serum S100 B and the level of serum CEM in the slow flow/no-reflow group were higher than those in the normal flow group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that PSQI score>7,pre-expanded stent implantation,the number of stents≥2,the length of stents>18.20 mm,C1q level>179.51μg/mL,S100 B level>94.46 pg/mL,and CEM level>111.51 mg/g were risk factors for coronary slow flow/no-reflow after PCI in the elderly ACS patients(OR>1,P<0.05).Conclusions:PSQI score>7,pre-expanded stent implantation,the number of stents≥2,the length of stents>18.20 mm,C1q level>179.51μg/mL,S100 B level>94.46 pg/mL,and CEM level>111.51 mg/g are the risk factors for coronary slow flow/no-reflow after PCI in the elderly ACS patients.