老年ST段抬高型急性心肌梗死急诊PCI术中无复流的危险因素  

Risk factors for no reflow during emergency PCI in aged STEMI patients

作　　者：徐明明[1] 夏林虎[1] XU Ming-ming;XIA Lin-hu(Interventional Catheter Room,People's Hospital of Bozhou City,Bozhou,Anhui,236000,China)

机构地区：[1]亳州市人民医院介入导管室,安徽亳州236000

出　　处：《心血管康复医学杂志》2022年第2期165-169,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:分析老年急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)术中发生无复流(NR)的危险因素。方法:收集在我院行急诊PCI的310例老年STEMI患者作为研究对象。根据是否术中发生NR,患者被分为NR组(86例)和复流组(224例)。探讨临床指标与NR发生的关系。结果:本研究中NR发生率为86/310(27.74%)。多因素Logistic分析结果显示,CHA2DS2-VASc评分、血浆D-D水平、术前TIMI低血流、支架长度是NR的独立危险因素(OR=1.028~5.287,P均<0.01)。ROC曲线分析显示,以CHA2DS2-VASc评分≥3.5分、血浆D-D水平≥180.0μg/L、支架长度≥28.5mm预测NR效能最高,曲线下面积分别为0.790、0.751、0.831,灵敏度分别为84.5%、70.5%、72.5%,特异度分别为90.0%、85.0%、89.3%。结论:老年ST段抬高型心肌梗死患者急诊PCI术中NR发生率较高,CHA2DS2-VASc评分、血浆D-D水平、支架长度对NR具有较高诊断效能。Objective:To analyze risk factors for no reflow(NR)during emergency percutaneous coronary intervention(PCI)in aged patients with acute ST segment elevation myocardial infarction(STEMI).Methods:A total of 310 aged STEMI patients undergoing emergency PCI in our hospital were collected.According to NR during PCI or not,patients were divided into NR group(n=86)and reflow group(n=224).Relationship between clinical indexes and NR occurrence were explored.Results:Incidence rate of NR was 86/310(27.74%).Multifactor Logistic analysis indicated that CHA2DS2-VASc score,plasma D-D level,preoperative TIMI low blood flow and stent length were independent risk factors for NR(OR=1.028~5.287,P<0.01 all).ROC curve analysis indicated that CHA2DS2-VASc score≥3.5 scores,plasma D-D level≥180.0μg/L and stent length≥28.5 mm possessed the highest predictive efficacy for NR;areas under curve(AUC)of them was 0.790,0.751 and 0.831 respectively;sensitivity of them was 84.5%,70.5%and 72.5%respectively,and specificity of them was 90.0%,85.0%and 89.3%respectively.Conclusion:Aged STEMI patients possess a higher incidence rate of NR during emergency PCI.CHA2DS2-VASc score,plasma D-D level and stent length possess high diagnostic efficacy for NR.

关 键 词：心肌梗死 血管成形术 气囊 冠状动脉 无复流现象 

分 类 号：R542.220.9[医药卫生—心血管疾病]