支架数目对经皮冠状动脉介入治疗相关的围术期心肌梗死的影响  

Effect of implanted stents on PCI-related periprocedural myocardial infarction

作　　者：张亚茹 薛政凯 缪帅[1] 徐玲霞[1] 王家瑞 车京津[1] 刘彤[1] 陶华岳[1] 陈康寅[1] Zhang Yaru;Xue Zhengkai;Miao Shuai;Xu Lingxia;Wang Jiarui;Che Jingjin;Liu Tong;Tao Huayue;Chen Kangyin(Department of Cardiology,Tianjin Medical University No.2 Hospital,Tianjin Key Laboratory of IonicMolecular Function of Cardiovascular Disease,Tianjin Institute of Cardiology,Tianjin 300211,China)

机构地区：[1]天津医科大学第二医院心脏科,天津市心血管病离子与分子机能重点实验室,天津心脏病学研究所,300211

出　　处：《中华老年心脑血管病杂志》2020年第8期828-831,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：天津市科技计划项目(16ZXMJSY00120,18ZXRHSY00180)。

摘　　要：目的探讨老年急性冠状动脉综合征(ACS)患者PCI置入支架数目与围术期心肌梗死(PMI)发生率的关系。方法连续收集2016年6月~2019年8月在天津医科大学第二医院心内科接受择期PCI的年龄>60岁老年ACS患者100例,根据置入支架数目分为单支架组64例(置入支架1枚);多支架组36例(置入支架≥2枚)。比较2组PMI发生率,多因素二元logistic回归分析影响因素。结果100例入选患者中,PMI发生率为22.0%。单支架组较多支架组PMI发生率显著降低(15.6%vs 33.3%,P=0.040)。术后1个月随访期间,2组均未发生主要不良心血管事件,2组出血事件发生率比较,无统计学差异(P=0.888)。多因素二元logistic回归分析显示,支架数目(OR=3.22,95%CI:1.16~8.92,P=0.024)和用替格瑞洛(OR=0.54,95%CI:0.31~0.92,P=0.024)是PCI相关PMI的独立预测因素。结论随着PCI置入支架数增多,老年ACS患者PCI相关PMI的发生率增高。Objective To study the relationship between the number of implanted stents and the incidenc of PCI-related periprocedural myocardial infarction(PMI)in elderly ACS patients.Methods One hundred>60 years old ACS patients who underwent elective PCI in our hospital from June 2016 to August 2019 were divided into one stent group(n=64)and≥2 stents group(n=36).The incidence of PCI-related PMI was compared between the two groups.The influencing factors of PCI-related PMI were analyzed by multivariate binary logistic regression analysis.Results The incidence of PCI-related PMI was 22.0%in the 100 elderly ACS patients included in this study and was significantly lower in≥2 stents group than in one stent group(15.6%vs 33.3%,P=0.040).No major adverse cardiovascular event occurred in two groups and no significant difference was detected in the incidence of hemorrhage between the two groups during the 1-month follow-up period(P=0.888).Tht number of implanted stents and the use of ticagrelor were the independent risk factors for PCI-related PMI in elderly ACS patients(OR=3.22,95%CI:1.16-8.92;OR=0.54,95%CI:0.31-0.92,P<0.05).Conclusion The incidence of PCI-related PMI increases with the number of implanted stents in elderly ACS patients.

关 键 词：支架 急性冠状动脉综合征 经皮冠状动脉介入治疗 围手术期 心肌梗死 

分 类 号：R541.4[医药卫生—心血管疾病]