青年STEMI患者急诊PCI术后无复流发生相关危险因素分析

Analysis of related risk factors affecting no reflow after emergency PCI in young patients with STEMI

目的:探讨青年急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)术后无复流发生的相关危险因素。方法:将2015年6月~2020年5月我院急诊科158例青年STEMI患者分为正常血流组与无复流组,对其相关资料进行比较。结果:无复流发生率为15.82%,单因素分析发现主要因素为BMI、冠状动脉病变血管数、Killip分级、发病至手术时间、糖尿病病史、LVEF、乳酸脱氢酶、预扩球囊直径及球囊扩张次数。多因素Logistic回归分析显示,糖尿病病史(OR=52.774,95%CI:5.027~553.978)、LVEF越小(OR=0.484,95%CI:0.341~0.688)及预扩球囊直径越小(OR=15.192,95%CI:2.933~78.692)提示术后无复流(P<0.05)。结论:糖尿病病史、LVEF及预扩球囊直径为青年STEMI患者无复流发生的预测因素。

Objective:To explore the associated risk factors for young patients with acute ST elevation myocardial infarction(STEMI)after emergency percutaneous coronary intervention(PCI).Methods:158 young STEMI patients admitted to the emergency department of our Hospital from June 2015 to May 2020 were divided into normal blood flow group and no refold group,and the relevant data were compared.Results:The incidence of no reflow was 15.82%.Results from the univariate analysis were found that the main influencing factors were BMI,the number of coronary artery lesions,Killip grade,the time from onset to operation,history of diabetes,LVEF,lactate dehydrogenase,the diameter of pre expanded balloon and the times of balloon expansion.Multivariate logistic regression analysis showed that the diabetes history(OR=52.774,95%CI:5.027~553.978),the smaller the LVEF(OR=0.484,95%CI:0.341~0.688)and diameter of pre expanded balloond(OR=15.192,95%CI:2.933~78.692)suggesting no reflow after surgery(P<0.05).Conclusions:The diabetes history,LVEF and diameter of pre expanded balloond can be used as predictive factors of the occurrence of no-reflow in young STEMI patients.