急诊介入慢血流的发生及预后与同型半胱氨酸水平的相关性  

Occurrence and prognosis of coronary slow flow in emergency percutaneous coronary intervention: correlations with homocysteine

作　　者：吴焱贤[1,2] 钟建开[2] 陈玉映[2] 陈盈文[2] 黎文生[2] 吴赛珠[1] 

机构地区：[1]南方医科大学南方医院心内科,广东广州510515 [2]南方医科大学附属顺德第一人民医院心内科,广东顺德528300

出　　处：《南方医科大学学报》2013年第3期416-419,共4页Journal of Southern Medical University

基　　金：广东省药学会基金(2011X38);佛山市科技计划项目(201108204)

摘　　要：目的探讨血同型半胱氨酸(HCY)与急诊PCI出现冠状动脉慢血流现象(CSF)的相关性,以及血Hcy高低对CSF患者预后的影响。方法入选138例接受急诊PCI患者,根据术中是否出现CSF分为CSF组及对照组,比较两组患者HCY水平;然后对CSF进行亚组分析,根据HCY水平将CSF组分为HCY轻度升高组和HCY中度升高组,比较2组患者住院期间以及3个月随访的左室射血分数(LVEF)、主要不良心血管事件(MACE)及与HCY水平的相关性。结果与对照组比较,CSF组患者患者血HCY水平明显升高,差异具有统计学意义(P=0.001);对CSF组进行亚组分析,与HCY轻度升高组相比,HCY中度升高组术后3个月LVEF值明显降低(P=0.031),主要心血管事件MACE发生率明显升高(P=0.019);HCY水平与术后3个月LVEF值呈负相关(r=-0.310,P=0.036),与术后3个月MACE(r=0.342,P=0.02)呈正相关,差异均具有统计学意义。结论血HCY水平与急诊经皮冠状动脉介入治疗PCI出现CSF情况密切相关,同时HCY水平升高,将影响患者的左室射血分数的恢复及增加MACE发生率。Objective To investigate the correlation of the occurrence and prognosis of coronary slow flow phenomenon （CSF） with blood homocysteine （Hcy） levels in patients receiving emergency percutaneous coronary intervention therapy （PCI）. Methods From January, 2010 to December, 2011, 138 patients with ST-elevation myocardial infarction received emergency angioplasty, among whom 46 patients developed CSF and 92 did not （control group）. Blood Hcy levels were determined in these patients. The patients with CSF were classified into two groups with mild and moderate Hcy elevations （32 and 14 cases, respectively）, and the left ventricular ejection fraction （LVEF） during hospitalization and at 3 months of follow-up as well as major adverse cardiac events （MACE） were compared between the two groups and analyzed for their association with Hcy level. Results The patients with CSF showed significantly higher blood Hcy levels than the control patients （P=0.001）. At 3 months of follow-up, the patients with CSF and moderate Hcy elevation had significantly lower LVEF （P=0.031） and higher incidence of MACE （P=0.019） than those with mild Hcy elevation. Hcy levels were negatively correlated with LVEF （r=-0.310, P=0.036） and positively with MACE （r=0.342, P=0.02）. Conclusion A high blood Hcy level is closely correlated with the occurrence of CSF in emergency PCI, affects the recovery of LVEF and increases the incidence of MACE.

关 键 词：急诊介入治疗 慢血流现象 同型半胱氨酸 左室射血分数 主要心血管事件 

分 类 号：R541.4[医药卫生—心血管疾病]