女性心梗患者急诊冠状动脉介入术后无复流的独立预测因素  

A prediction model for no-reflow in female patients treated with primary percutaneous coronary intervention

作　　者：徐祗栋 李勇[2] 陈玉国[2] 徐峰[2] 

机构地区：[1]郯城县第一人民医院急诊科,山东省临沂市276199 [2]山东大学齐鲁医院急诊科,山东省临沂市276199

出　　处：《中国心血管病研究》2016年第1期38-41,共4页Chinese Journal of Cardiovascular Research

基　　金：山东省自然科学基金资助项目（项目编号：Y2007C075）;山东省软科学研究计划资助项目（项目编号：2008RKB060）

摘　　要：目的 探讨女性心梗患者经急诊冠状动脉介入术后无复流现象的独立预测因素.方法 选取我院心内科于2012年5月至2013年7月期间收治的321例女性心梗急诊冠状动脉介入术患者作为研究对象,根据术后有无复流分为观察组和对照组.观察组为无复流组,160例;对照组为复流正常组,161例.对比两组患者的临床基线特征、冠状动脉造影及冠状动脉介入特征,通过单变量和多变量Logistic回归的方法评价女性心梗患者急诊冠状动脉介入术后未出现复流现象的独立预测因素.结果 女性心梗患者急诊冠状动脉介入术后未出现复流的独立预测因素为：患者的人院收缩压＜100 mm Hg、靶病变长度＞20 mm、侧支循环判定为0～1级、冠状动脉介入治疗前血栓负荷评分≥4、冠状动脉介入治疗前曾使用主动脉内气囊反搏.当患者分别具备0、1、2、3、4、5个独立预测因素时,无复流的发生概率分别为0％、11.2％、14.1％、36.9％、56.3％、82.4％（P＜0.05）,即患者的无复流率和独立预测因素的数量成正比.结论 女性患者经急诊冠状动脉介入后无复流现象与入院收缩压、靶病变长度、侧支循环的级别、介入治疗前血栓负荷评分及使用主动脉内气囊反搏有关.Objective To evaluate the independent no-reflow predictions during primary percutaneous coronary intervention in female patients with ST-segment elevation acute myocardial infarction under the fast devel- opment of interventional strategies, in order to create a model for predicting no-reflow status. Methods Select 321 female patients with ST-segment elevation acute myocardial infarction successfully treated with primary percu- taneous coronary intervention and divide them into two groups. One was no-reflow group while the other was nor- mal reflow group. Univariate and multivariate logistic regression were used to evaluate the independent no-reflow predictions during primary percutaneous coronary intervention in female patients with ST-segment elevation acute myocardial infarction. Results The univariate and multivariate logistic regression showed that SBP lower than 100 mm Hg, target lesion length longer than 20 mm, collateral circulation 0-1, pre-PPCI thrombus score higher than 4, and intra-aortic balloon pulsation use before primary percutaneous coronary intervention were the independent no- reflow predictions. And the no-reflow incidence rate increased as the number of independent predictions increased. While there exist 0, 1, 2, 3, 4, 5 independents, the no-reflow incidence rate was 0%, 11.2%, 14.1%, 36.9%, 56.3% and 82.4%. Conclusion The independent no-reflow predictions are as follows： the SBP is lower than 100 mm Hg, the target lesion is length longer than 20 mm, the collateral circulation is 0-1, pre-PPCI thrombus score is higher than 4, and intra-aortic ballon pulsation use before primary percutaneous coronary intervention.

关 键 词：女性患者 急性心肌梗死 经皮冠状动脉介入治疗 无复流 独立预测因素 

分 类 号：R542.22[医药卫生—心血管疾病]