急性心肌梗死PCI术后冠状动脉无复流的危险因素及对血清ITLN-1、sICAM-1水平的作用

Risk factors of coronary no-reflow and their influence on intelectin 1 and soluble intercellular adhesion molecule in patients with acute myocardial infarction after PCI

目的探讨急性心肌梗死(AMI)经皮冠状动脉介入治疗(PCI)术后冠状动脉(冠脉)无复流的危险因素及对血清内凝集蛋白-1(ITLN-1)、可溶性细胞间黏附分子-1(sICAM-1)水平的作用。方法选择2021年1月至2022年12月于平顶山市第一人民医院接受PCI的100例AMI患者进行研究,根据PCI术后冠脉血流再通情况分为无复流组、正常血流组,比较无复流组和正常血流组血清ITLN-1、sICAM-1水平,并分析急性心肌梗死PCI术后冠脉无复流的危险因素。结果100例患者中,18例患者PCI术后出现无复流,发生率为18.00%;单因素分析显示,无复流组与正常血流组的年龄、吸烟、病变血管支数、Killip分级、症状出现至PCI时间比较,差异有统计学意义(P<0.05);无复流组血清ITLN-1水平为(121.33±26.67)ng/ml,明显低于正常血流组的(299.53±34.58)ng/ml,sICAM-1水平为(579.03±56.22)ng/L,明显高于正常血流组的(338.23±42.98)ng/L,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄、吸烟、病变血管支数、Killip分级、症状出现至PCI时间、sICAM-1均是影响急性心肌梗死患者PCI术后冠脉无复流的危险因素,血清ITLN-1是保护因素(P<0.05)。结论急性心肌梗死PCI术后冠脉无复流的影响因素较多,包括年龄、吸烟、病变血管支数、Killip分级、症状出现至PCI时间、血清ITLN-1、sICAM-1,应密切关注。

Objective To investigate the risk factors of coronary no-reflow and their influence on intelectin 1(ITLN-1)and soluble intercellular adhesion molecule-1(sICAM-1)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods AMI patients(n=100)received PCI were chosen from the First People’s Hospital of Pingdingshan City from Jan.2021 to Dec.2022.All patients were divided,according to coronary flow recanalization,into no-reflow group and normal flow group.The levels of ITLN-1 and sICAM-1 were compared between 2 groups,and risk factors of coronary no-reflow was analyzed in AMI patients after PCI.Results In 100 patients,there were 18 with no-reflow after PCI and incidence rate was 18.00%.The results of single-factor analysis showed that differences in age,smoking,number of disease vessel,Killip grades and time from symptoms occurred to PCI had statistical significance between no-reflow group and normal flow group(P<0.05).The level of ITLN-1 was(121.33±26.67)ng/ml in no-reflow group and(299.53±34.58)ng/ml in normal flow group,and level of sICAM-1 was(579.03±56.22)ng/L in no-reflow group and(338.23±42.98)ng/L in normal flow group(P<0.05).The results of multi-factor Logistic regression analysis showed that age,smoking,number of disease vessel,Killip grades,time from symptoms occurred to PCI and sICAM-1 all were risk factors and ITLN-1 was a protective factor(P<0.05)affecting coronary no-reflow in AMI patients after PCI.Conclusion There are many factors affecting coronary no-reflow,including age,smoking,number of disease vessel,Killip grades,time from symptoms occurred to PCI,sICAM-1 and ITLN-1,which should be paid a close attention to.