基于Logistic回归模型分析120例STEMI患者PCI术后心肌组织灌注的相关影响因素  

Logistic regression model-based analysis of factors influencing myocardial tissue perfusion after PCI in 120 patients with STEMI

作　　者：武亚茹 Wu Yaru(The First People's Hospital of Zhoukou,Henan 466700)

机构地区：[1]周口市第一人民医院,河南周口466700

出　　处：《辽宁医学杂志》2024年第3期27-30,共4页Medical Journal of Liaoning

摘　　要：目的探讨基于Logistic回归模型分析急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术后心肌组织灌注的相关影响因素,为临床制定防治策略提供依据。方法选取2021年10月至2022年10月本院收治的120例STEMI患者为研究对象,根据PCI术后心肌组织灌注情况分为灌注不良组36例、灌注良好组84例。采用单因素、Logistic多因素回归分析STEMI患者PCI术后心肌组织灌注的影响因素。采用受试者工作特征(ROC)曲线评价Logistic多因素回归模型对PCI术后心肌组织灌注的预测价值。结果灌注不良组再灌注时间大于灌注良好组,LVEF低于灌注良好组,CX3CL1、CRP、NLR、MHR水平及冠状动脉内应用替罗非班、术中慢血流/无复流发生比例高于灌注良好组(P<0.05);Logistic多因素回归分析显示再灌注时间、CX3CL1、CRP、NLR、MHR是PCI术后心肌组织灌注危险因素,LVEF是其保护因素(P<0.05);ROC分析显示Logistic多因素回归模型预测PCI术后心肌组织灌注发生的AUC为0.905(95%CI:0.852~0.961)。结论再灌注时间、LVEF、CX3CL1、CRP、NLR、MHR是STEMI患者PCI术后心肌组织灌注不良的影响因素,应针对上述影响因素进行针对性干预,以降低PCI术后心肌组织灌注不良发生风险。Objective To explore the factors influencing myocardial tissue perfusion after percutaneous coronary intervention(PCI)in patients with acute ST-segment elevation myocardial infarction(STEMI)based on logistic regression model analysis,and to provide a basis for clinical formulation of prevention and treatment strategies.Methods One hundred and twenty patients with STEMI admitted to our hospital from October 2021 to October 2022 were selected for the study,and were divided into 36 cases in the poorly perfused group and 84 cases in the well perfused group according to the perfusion of myocardial tissue after PCI.The factors influencing myocardial tissue perfusion after PCI in STEMI patients were analyzed using univariate and logistic multi-factor regression.Subject work characteristic(ROC)curves were used to evaluate the predictive value of logistic multifactor regression models on myocardial tissue perfusion after PCI.Results The reperfusion time was greater in the poorly perfused group than in the well perfused group,LVEF was lower than in the well perfused group,CX3CLI,CRP,NLR,MHR levels and intracoronary application of tirofiban,and the proportion of occurrence of slow/no intraoperative flow were higher than in the well perfused group(P<0.05);logistic multifactorial regression analysis showed that reperfusion time,CX3CL1,CRP NLR,and MHR were risk factors for myocardial tissue perfusion after PCI,and LVEF was its protective factor(P<0.05);ROC analysis showed that the logistic multifactor regression model predicted the occurrence of myocardial tissue perfusion after PCI with an AUC of 0.905(95%CI:0.852 to 0.961).Conclusion Reperfusion time,LVEF,CX3CL1,CRP,NLR,and MHR are the influencing factors of poor myocardial tissue perfusion after PCI in patients with STEMI,and targeted interventions should be made to address these influencing factors to reduce the risk of poor myocardial tissue perfusion after PCI.

关 键 词：急性ST段抬高型心肌梗死 经皮冠状动脉介入 心肌组织灌注 LOGISTIC 

分 类 号：R542.22[医药卫生—心血管疾病]