急性心肌梗死患者经皮冠脉介入术后无/慢复流发生与炎症  

Inflammation Markers in Patients with Acute Myocardial Infarction No or Slow Reflow after Parcutaneous Coronary Intervention

作　　者：丛洪良[1] 杜纪兵[2] 齐学艳[3] 张梅[3] 王伟[3] 陈树涛[3] 周长钰[3] 李广平[3] 黄体钢[1] 

机构地区：[1]天津市胸科医院心脏科,天津300051 [2]天津市心血管病学研究所,天津300051 [3]天津医科大学第二医院心脏科,天津300051

出　　处：《中华高血压杂志》2007年第6期485-488,共4页Chinese Journal of Hypertension

摘　　要：目的探讨急性心肌梗死患者行冠脉介入术(PCI)后无/慢复流现象发生与炎症的关系。方法前瞻性研究656例急性心肌梗死行PCI的患者,其中632例患者随访至一年,60例发生PCI术后无/慢复流现象为复流不良组;从其余的572例患者中,用Excel随机函数表随机抽取120例患者设为对照组,为避免统计学偏差。结果复流不良组炎症指标,如白细胞总数、中性粒细胞总数、高敏C反应蛋白,以及死亡率、心脏不良事件、糖尿病及胰岛素水平均高于对照组(P<0.05或P<0.01);复流不良患者左室射血分数减低、左室舒张末期内径增大(P<0.01)。结论炎症反应与急性心肌梗死患者PCI术后无/慢复流现象的发生有关,并严重影响患者的预后。Objective To evaluate the relationship between inflammation response in no or slow-reflow phenomenon in patients with acute myocardial infarction （AMI） after percutaneous coronary intervention （PCI）. Methods We prospectively investigated 656 patients with AMI after PCI, 632（96.3G） patients were followed up for one year. Sixty patients were categorized as angiographic no or slow-reflow, 120 patients were randomly selected from 572 patients with normal coronary reflow and served as controls. Results The inflammation factors including leukocyte count, blood platelet and hsCRP level were significant higher in no slow-reflow patients than normal reflow group, prevalence rate of diabetes and hyperinsulinemia in no or slow patients were higher than that in controls. In hospital and follow up mortalities and cardiac events were much higher in no or slow patients than that in normal reflow group（P〈0. 05 or P〈0. 01）, which was associated with significantly decreases in LVEF and increases in LVEDD（P〈0.01）. Conclusion Inflammation plays a critical role in the no or slow-reflow phenomenon. Additionally, no/slow-reflow is a serious complication after PCI predicting poor left ventricular functional recovery and low survival rate in patients with AMI.

关 键 词：急性心肌梗死 炎性反应 直接PCI 无/慢复流现象 

分 类 号：R542.22[医药卫生—心血管疾病]