心肌梗死行冠状动脉介入治疗后无复流现象临床分析  

No-reflow phenomenon after emergency percutaneous coronary intervention in acute myocardial infarction

作　　者：王金波[1] 张建维[1] 曹树军[1] 胡硕强[1] 杨清[2] 杨士伟[2] 

机构地区：[1]首都医科大学大兴医院心内科,北京102600 [2]首都医科大学附属北京安贞医院心内科,北京100029

出　　处：《中华实用诊断与治疗杂志》2014年第3期236-238,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：国家自然科学基金(81100143)

摘　　要：目的探讨急性ST段抬高型心肌梗死患者行急诊冠状动脉介入术治疗后无复流现象的影响因素及对预后的影响。方法行急诊冠状动脉介入治疗的急性ST段抬高型心肌梗死患者385例，根据治疗后TIMI血流情况分为无复流组（TIMIO～2级）及TIMI3级组，记录2组住院期间不良事件发生情况，分析无复流现象的影响因素及对预后的影响。结果本组患者行急诊冠状动脉介入术后无复流发生率为40％；应激性高血糖、高尿酸血症、高敏C反应蛋白〉3mg／L是急诊冠状动脉介入术后无复流现象发生的独立危险因素；无复流现象可增加患者住院期间病死率及复合终点事件发生率。结论急诊冠状动脉介入术治疗急性ST段抬高型心肌梗死患者后无复流现象发生率高，无复流现象可增加心血管不良事件发生率。Objective To explore the risk {actors of no-reflow phenomenon and the influence on prognosis in patients with ST-segment elevation myocardial infarction （STEMI） after emergency percutaneous coronary interventions （PCI）. Methods A total of 385 STEMI patients undergoing emergency PCI were divided into no-reflow group （TIMI 0 to 2） and TIMI 3 group according to thrombolysis in myocardial infarction trial after PCI. The in-hospital adverse events were recorded, and the risk factors of no-reflow phenomenon and its influence on prognosis were analyzed. Results The incidence of no-reflow phenomenon was 400/oo after emergency PCI. The independent risk factors of no-reflow phenomenon included stress hyperglycemia, hyperuricemia and high level of high sensitivity C-reactive protein （〉3 mg/L）. No-reflow phenomenon increased the in-hospital fatality rate and incidence of adverse events. Conclusions The incidence of no- reflow phenomenon is high after emergency PCI for STEMI, which increases the incidence of adverse events.

关 键 词：急性ST段抬高型心肌梗死 无复流现象 危险因素 急诊冠状动脉介入治疗 

分 类 号：R542.22[医药卫生—心血管疾病]