门-囊时间对急诊冠状动脉介入术后慢血流或无复流的影响  

Impact of the door-to-balloon time on the slow/no-reflow phenomenon after emergency percutaneous coronary intervention

作　　者：郭瑛[1,2] 王骏[1,2] 孙育民[1,2] 张天嵩[1,3] 张雁[1,2] 周贇[1,2] 徐志强[1,2] 黄少华[1,2] 陶文其[1,2] 俞帅[1,2] 连敏[1,2] 蒋巍[1,2] 

机构地区：[1]上海市静安区中心医院 [2]复旦大学附属华山医院静安分院心内科,上海200040 [3]复旦大学附属华山医院静安分院科教部,上海200040

出　　处：《中华实用诊断与治疗杂志》2015年第7期670-672,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：静安区卫生系统医学学科建设项目(JWXK201201)

摘　　要：目的探讨急性ST段抬高型心肌梗死(acute ST-segment elevation myocardial infarction,ASTEMI)患者门-囊时间与冠状动脉介入术(percutaneous coronary intervention,PCI)治疗后发生慢血流或无复流现象的关系。方法行急诊PCI治疗的ASTEMI患者185例,根据门-囊时间分为4组,分别为0~1h30 min组60例,>1h30 min^3h组66例,>3~6h组30例和>6~12h组29例,应用单因素、多因素logistic回归分析急诊PCI后发生慢血流或无复流现象的影响因素。结果 185例患者中26例(14%)发生慢血流或无复流,0~1h30min组、>1h30min^3h组、>3~6h组及>6~12h组慢血流或无复流发生率分别为6.67%、10.61%、16.67%及34.48%,组间比较差异均有统计学意义(P<0.01),门-囊时间(OR=1.870,95%CI:1.200~2.900,P=0.006)与体质量指数(OR=1.440,95%CI:1.130~1.840,P=0.030)与急诊PCI后慢血流或无复流现象明显相关;随门-囊时间延长,术后慢血流或无复流现象的发生率逐渐升高。结论门-囊时间、体质量指数是ASTEMI急诊PCI后发生慢血流或无复流的独立预测因素。Objective To evaluate the relationship between the door-to-balloon time and the slow/no-reflow phenomenon after percutaneous coronary intervention （PCI） in patients with acute ST-segment elevation myocardial infarction （ASTEMI）. Methods A total of 185 ASTEMI patients undergoing emergency PCI were divided into 4 groups according to door-to-ballon time, 0~1.5 hours group （n=60）, 1.5~3 hours group （n=66）, 3~6 hours group （n=30） and 6~12 hours group （n = 29）. The impact factors of the slow/no-reflow phenomenon after emergency PCI were analyzed by univariate and multivariate logistic regression analysis. Results The slow/no-reflow phenomenon after PCI occurred in 26 patients （14%）. Door-to-ballontime （OR=1.870, 95%CI： 1.200 to 2. 900, P=0.006） and body mass index （OR= 1. 440, 95%CI： 1. 130 to 1. 840, P= 0. 030） were obviously correlated with the slow/no reflow phenomenon. The incidence of the slow/no-reflow phenomenon increased with the prolonged door-to-ballon time. Conclusion Door-toballon and body mass index are the independent predictors of the slow/no-reflow phenomenon after emergency PCI in ASTEMI patients.

关 键 词：急性心肌梗死 冠状动脉介入术 慢血流 无复流 门-囊时间 

分 类 号：R542.22[医药卫生—心血管疾病]