敏感指标对急性心肌梗死术后患者血栓形成的预测价值  

Clinical application value of sensitive indicators foRpostoperative thrombosis in patients with acute myocardial infarction

作　　者：付健[1] 马瑛[1] 彭晓红[1] 宋蓓[1] FU Jian;MA Ying;PENG Xiaohong(Second Department of Critical Care Medicine,the First Affiliated Hospital of Xinjiang Medical University,Xinjiang,Urumqi 830000,China)

机构地区：[1]新疆医科大学第一附属医院重症医学二科,乌鲁木齐市830000

出　　处：《河北医药》2023年第15期2302-2304,2309,共4页Hebei Medical Journal

基　　金：新疆维吾尔自治区自然科学基金资助项目(编号:2017D01C298)。

摘　　要：目的分析急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术后敏感指标对血栓形成的预测价值。方法选择是2019年1月至2021年1月接受PCI手术治疗的AMI患者60例,筛选敏感指标,以是否形成支架血栓分组,将20例形成支架血栓的患者作为观察组,40例未形成支架血栓的患者作为对比组,比较2组质量敏感指标,Logistic回归分析影响支架血栓形成的危险因素,评估敏感性指标对AMI患者PCI术后支架血栓形成的预测价值。绘制ROC曲线,计算曲线下面积(AUC),比较质量敏感指标预测支架血栓的灵敏度、特异度。结果观察组病变血管、支架总长度与对比组比较,差异无统计学意义(P>0.05)。观察组病变血管支数、支架数目、病变血管直径、支架贴壁不良、停用抗血小板药物与对比组比较,差异有统计学意义(P<0.05)。Logistic回归分析,病变血管支数、支架数目、病变血管直径、支架贴壁不良、停用抗血小板药物是导致支架血栓形成的危险因素(P<0.05)。病变血管支数、支架数目、病变血管直径、支架贴壁不良、停用抗血小板药物联合预测支架血栓形成的灵敏度、特异度均高于单一预测(P<0.05),AUC分别是0.864、0.824、0.658、0.714、0.824、0.804(P<0.05)。结论病变血管支数、支架数目、病变血管直径、支架贴壁不良、停用抗血小板药物联合对支架血栓形成具有较高的预测价值。Objective To analyze the clinical application value of sensitive indicators foRpostoperative thrombosis in patients with acute myocardial infarction(AMI)underwent percutaneous coronary intervention(PCI).Methods A total of 60 AMI patients underwent PCI from January 2019 to January 2021 were recruited.Quality-sensitive indicators were screened.According to the presence oRabsence of stent thrombosis,twenty patients with stent thrombosis(ST)were included in the observation group,and forty patients without ST were included in the control group.Sensitive indicators were compared between groups.Logistic regression analysis was performed to identify risk factors foRST afteRPCI in AMI patients.The receiveRoperating characteristic(ROC)curves were plotted,and the area undeRthe curve(AUC),sensitivity and specificity of sensitive indicators were calculated to assess theiRprognostic value.Results There were no significant differences in the total length of diseased blood vessels and stents between the observation group and the control group(P>0.05).There were significantly differences in the numbeRof diseased branches,the numbeRof stents,the diameteRof diseased blood vessels,the proportions of pooRattachment of stents,and the discontinuation of antiplatelet drugs between groups(P<0.05).Logistic regression analysis showed that the numbeRof diseased branches,the numbeRof stents,the diameteRof diseased blood vessels,pooRstent adherence,and the discontinuation of antiplatelet drugs were risk factors foRST in AMI patients underwent PCI(P<0.05).The sensitivity and specificity of the combination detection of the numbeRof diseased branches,the numbeRof stents,the diameteRof the diseased blood vessels,pooRstent adherence,and the discontinuation of antiplatelet drugs in predicting ST in AMI patients underwent PCI were all significantly higheRthan those of a single detection,with the area undeRthe curve(AUC)was 0.864,0.824,0.658,0.714,0.824,0.804 respectively,(P<0.05).Conclusion The combination detection of the numbeRof diseased branches

关 键 词：质量敏感指标 心肌梗死急性 支架内血栓 

分 类 号：R542.22[医药卫生—心血管疾病]