| 摘要: |
| 目的 探讨急性ST段抬高心肌梗死（ST-segment elevation myocardial infarction，STEMI）患者行急诊冠状动脉介入术（percutaneous coronary intervention，PCI）中发生无复流的影响因素。方法 将2012年6月至2013年1月本院收治的行急诊PCI治疗的急性STEMI患者（n=92），分为正常复流组（n=73）和无复流组（n=19）。通过比较两组的临床症状来分析无复流发生的相关影响因素。结果 急性STEMI患者行急诊PCI后无复流发生率为20.7%（19/92），无复流组与正常复流组相比，两组之间入院时的收缩压（SBP）、2型糖尿病患病数、肌钙蛋白T峰值、发病到再灌注时间、球囊扩张次数和靶血管植入支架数量差异均有统计学意义（P<0.05）；经多因素logistic 回归分析显示入院SBP<100 mmHg （1 mmHg=0.133 kPa）、合并2型糖尿病、球囊扩张次数、肌钙蛋白T峰值、右冠状动脉病变和发病至再灌注时间是急诊PCI术后无复流发生的危险因素。结论 急性STEMI患者行急诊PCI后无复流发生与入院SBP<100 mmHg、合并2型糖尿病、球囊扩张次数、肌钙蛋白T峰值、右冠状动脉病变及发病至再灌注时间这6种临床因素具有相关性。 |
| 关键词: 心肌梗死 急诊处理 经皮冠状动脉 介入术 无复流 |
| DOI：10.3724/SP.J.1008.2014.00456 |
| 投稿时间：2013-08-27修订日期：2014-01-04 |
| 基金项目:湖北省自然科学基金（2012FFB06803）；湖北省卫生厅青年人才项目（QJX201224）. |
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| No-reflow during emergency percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction：an analysis of influencing factors |
| FU Wen-bo,DING Shi-fang,CHEN Zhi-nan,JIANG Ju-quan,GONG Zhi-gang,LI Zhi-gang,LU Qing,WANG Ren-xue |
(Department of Cardiology, Wuhan General Hospital, PLA Guangzhou Military Area Command, Wuhan 430070, Hubei, China
*Corresponding author.) |
| Abstract: |
| Objective To identify the factors of no-reflow during emergency percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods A total of 92 patients with acute STEMI treated with PCI were divided into normal reflow group(73 patients ) and no-reflow group (19 patients) from June 2012 to January 2013.The influencing factors of no-reflow were clarified by comparing clinical symptoms of the two groups. Results The no-reflow rate after undergoing emergency PCI was 20.7% in 92 acute STEMI patients.The systolic blood pressure (SBP), type 2 diabetes, troponin T peak, period from disease onset to reperfusion, balloon expansion times and stent number of the target blood vessel were significantly different between the two groups (P<0.05). Multivariate logistic regression analysis identified that low SBP (SBP<100 mmHg, 1 mmHg=0.133 kPa), type 2 diabetes, balloon expansion times, troponin T peak, right coronary artery lesions and period from disease onset to reperfusion were the risk factors for no-reflow during PCI in patients with STEMI. Conclusion No-reflow following emergency PCI in acute STEMI patients is associated with six clinical factors: SBP<100 mmHg, type 2 diabetes, balloon expansion times, troponin T peak, right coronary artery lesions and period from disease onset to reperfusion. |
| Key words: myocardial infarction emergency treatment percutaneous coronary intervention no-reflow |
