心肌挽救指数对急性ST段抬高型心肌梗死患者左心室重构的预测价值  

Predictive value of myocardial salvage index to left ventricular remodeling in patients with acute ST-segment elevation myocardial infarction

作　　者：王婧辰 张师儒 焦云娣[1] 张男[1] 段玮丽 孙志军[1] 孙兆青[1] WANG Jing-chen;ZHANG Shi-ru;JIAO Yun-di;ZHANG Nan;DUAN Wei-li;SUN Zhi-jun;SUN Zhao-qing(Department of Cardiology,Shengjing Hospital of China Medical University,Shenyang 110022,China)

机构地区：[1]中国医科大学附属盛京医院心血管内科,辽宁省沈阳市110022

出　　处：《中国心血管病研究》2022年第8期701-705,共5页Chinese Journal of Cardiovascular Research

基　　金：国家重点研发计划项目(2018YFC1311600)。

摘　　要：目的探讨心肌挽救指数(MSI)对急性ST段抬高型心肌梗死(STEMI)患者行经皮冠状动脉介入治疗(PCI)后左心室重构的预测价值。方法采用病例对照研究方法,纳入2016年12月至2019年1月于中国医科大学附属盛京医院行PCI的首次STEMI患者80例,并均于术后1周和6个月行心脏磁共振检查,计算MSI。根据左心室收缩末期容积增加是否≥15%将STEMI患者分为两组:左心室重构组(18例)和无左心室重构组(62例)。对比两组患者的临床资料,使用logistic回归模型分析MSI对STEMI患者行PCI后发生左心室重构的预测价值。结果左心室重构组中总胆固醇[(5.3±1.2)mmol/L比(4.6±1.1)mmol/L,P<0.05]及入院-球囊扩张时间均高于无左心室重构组[134.0(85.0,177.0)min比87.5(71.0,129.0)min,P<0.05],MSI小于无左心室重构组[(47.9±18.4)比(60.4±21.0),P<0.05]。多变量logistic回归分析显示,MSI与STEMI患者行PCI后左心室重构的发生密切相关(P=0.039,OR=0.971,95%CI 0.944~0.999)。结论MSI是STEMI患者行PCI后发生左心室重构的独立预测因素。Objective To investigate the predictive value of myocardial salvage index(MSI)on left ventricular remodeling in patients with acute ST-segment elevation myocardial infarction(STEMI)underwent percutaneous coronary intervention(PCI).Methods In this case-control study,a total of 80 patients with STEMI who underwent PCI in Shengjing Hospital of China Medical University from December 2016 to January 2019 were included.All patients underwent cardiac magnetic resonance within one week and six months after PCI treatment,and MSI was calculated.Patients with STEMI were divided into left ventricular remodeling group(n=18)and no left ventricular remodeling group(n=62),according to whether the left ventricular end-systolic volume increased by 15%or more.The clinical data of the two groups were compared,and logistic regression model was used to analyze the predictive value of MSI on left ventricular remodeling in patients with STEMI underwent PCI.Results Compared with the no left ventricular remodeling group,patients in left ventricular remodeling group showed higher total cholesterol level[(5.3±1.2)mmol/L vs.(4.6±1.1)mmol/L,P<0.05]and door-to-balloon time[134.0(85.0,177.0)min vs.87.5(71.0,129.0)min,P<0.05]but lower MSI[(47.9±18.4)vs.(60.4±21.0),P<0.05].Multivariate logistic regression analysis showed that MSI was closely related to left ventricular remodeling after PCI in STEMI patients(P=0.039,OR=0.971,95%CI 0.944-0.999).Conclusions MSI is an independent predictor of left ventricular remodeling in patients with STEMI after PCI.

关 键 词：心肌挽救指数 左心室重构 急性ST段抬高型心肌梗死 心脏核磁共振 

分 类 号：R542.22[医药卫生—心血管疾病]