急诊PCI术后发生无复流与术前患者PLA值和肾功能变化的关系  

Relation between non-reflow after emergency PCI and changes in PLA values and renal function in patients before surgery

作　　者：王功旭 朱诗苗 WANG Gongxu;ZHU Shimiao(Department of Emergency,Affiliated Hospital of Xiangnan University,Chenzhou,Hunan,423000,China;Department of Rehabilitation,Affiliated Hospital of Xiangnan University)

机构地区：[1]湘南学院附属医院急诊科,湖南郴州423000 [2]湘南学院附属医院康复科

出　　处：《临床急诊杂志》2023年第4期207-211,共5页Journal of Clinical Emergency

摘　　要：目的:探讨术前血小板-白细胞聚集体(platelet-leukocyte aggregates,PLA)、肾功能与ST段抬高型急性心肌梗死(ST-segment elevation acute myocardial infarction,STEMI)患者行急诊经皮冠状动脉介入手术(percutaneous coronary intervention,PCI)后发生无复流的关系。方法:选取我院既往急诊PCI治疗术后出现心肌无复流患者68例作为无复流组,同期急诊PCI治疗术后心肌灌注恢复正常的患者130例作为对照组;查阅2组患者的年龄、性别、合并疾病、PCI介入治疗相关资料,采用logistic回归分析法探讨术前PLA值、肾功能与急诊PCI术后无复流的关系。结果:无复流组和对照组的血清三酰甘油(TG)、收缩压(SBP)、起病至PCI时间、病变血管支数、植入支架数、植入支架长度比较,差异有统计学意义(P<0.05);无复流组的术前PLA测定值为(68.21±9.42)%,高于对照组的(54.50±8.77)%,无复流组患者的估算的肾小球滤过率为(94.51±15.20)mL/(min·1.73 m^(2)),低于对照组的(103.75±18.17)mL/(min·1.73 m^(2)),差异均有统计学意义(P<0.05);logistic回归模型结果显示:TG升高、起病至PCI时间间隔长、术前PLA增高、估算的肾小球滤过率降低是STEMI患者PCI术后出现无复流的独立危险因素危险(P<0.05)。结论:影响STEMI患者PCI术后出现无复流的危险因素有多种,术前PLA增高、肾功能受损是STEMI患者PCI术后无复流的风险因素。Objective To investigate the relationship between preoperative platelet-leukocyte aggregates(PLA),renal function,and ST-segment elevation acute myocardial infarction(STEMI)in patients undergoing emergency percutaneous coronary intervention(PCI).Methods Selected 68 patients with myocardial no-reflow after emergency PCI treatment in our hospital(non-reflow group)and 130 patients with normal myocardial perfusion after emergency PCI treatment during the same period as control group;The data of gender,comorbidities,and PCI interventional treatment were analyzed by logistic regression analysis to investigate the relationship between preoperative PLA value,renal function,and no regurgitation after emergency PCI.Results The serum TG,SBP,the time from onset to PCI,the number of diseased vessels,the number of implanted stents,and the length of implanted stents in the non-reflow group and the control group were significantly different(P<0.05);The preoperative PLA value in the non-reflow group was(68.21±9.42)%,higher than that in the control group(54.50±8.77)%,and the estimated glomerular filtration rate in the non-reflow group was(94.51±15.20)mL/(min·1.73 m^(2)),lower than that in the control group(103.75±18.17)mL/(min·1.73 m^(2)),with statistical significance(P<0.05);The results of logistic regression model showed that the increase of TG,the long time interval from onset to PCI,the increase of preoperative PLA and the decrease of estimated glomerular filtration rate were independent risk factors for non-reflow in STEMI patients after PCI(P<0.05).Conclusion There are many risk factors that affect the occurrence of non-reflow in STEMI patients after PCI.The increase of preoperative PLA and the impairment of renal function are the risk factors of non-reflow in STEMI patients after PCI.

关 键 词：血小板-白细胞聚集体 肾功能 ST段抬高型急性心肌梗死 急诊经皮冠状动脉介入手术 无复流 

分 类 号：R541.4[医药卫生—心血管疾病]