急性心肌梗死PCI术后无复流/慢血流相关因素分析及预测价值  

Related factors and predictive value of no-reflow/slow flow in patients with acute myocardial infarction after percutaneous coronary intervention

作　　者：赵伟 杨小龙 金龙 马宏恩 Zhao Wei;Yang Xiaolong;Jin Long;Ma Hong'en(Department of Cardiovascular Medicine,Ninth Hospital of Xi'an City,Xi'an 710054,China;不详)

机构地区：[1]西安市第九医院心血管内科,西安1710054

出　　处：《中国循证心血管医学杂志》2024年第9期1124-1127,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的分析急性心肌梗死(AMI)经皮冠状动脉介入治疗(PCI)术后无复流/慢血流的相关影响因素及其预测效能,为临床早期干预提供参考。方法回顾性分析2021年3月至2023年3月于西安市第九医院行PCI的115例AMI患者临床资料,依据PCI术后是否出现无复流/慢血流,将其分为无复流/慢血流组和正常组。比较两组患者的临床资料及实验室检查结果,采用多因素Logistic回归分析AMI患者PCI术后无复流/慢血流的相关因素,并以受试者工作特征(ROC)曲线分析相关因素对AMI患者PCI术后无复流/慢血流的预测价值。结果单因素分析显示,年龄、血糖、收缩压(SBP)、发病至PCI时间、心率(HR)、修正休克指数(MSI)、D-二聚体、单核细胞/高密度脂蛋白胆固醇比值(MHR)与AMI患者PCI术后无复流/慢血流相关(P<0.05);多因素分析显示,血糖(OR=2.888,95%CI:1.274~6.547)、发病至PCI时间(OR=3.881,95%CI:1.625~9.270)、MSI(OR=54.341,95%CI:10.178~290.127)、D-二聚体(OR=35.801,95%CI:7.021~182.558)、MHR(OR=2.048,95%CI:1.502~2.795)是AMI患者PCI术后无复流/慢血流的独立危险因素(P<0.05)。ROC曲线显示,上述独立危险因素均对AMI患者PCI术后无复流/慢血流具有一定预测价值。结论血糖、发病至PCI时间、MSI、D-二聚体、MHR均与AMI患者PCI术后无复流/慢血流发生有关,具有一定预测价值。Objective To analyze the related factors and predictive efficacy of no-reflow/slow flow in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI),and provide reference for early clinical intervention.Methods AMI patients undergone PCI(n=115)were retrospectively analyzed in the Ninth Hospital of Xi'an City from Mar.2021 to Mar.2023.The patients were divided,according to whether no-reflow/slow flow occurrence after PCI or not,into no-reflow/slow flow group and normal group.The clinical materials and results of laboratory examination were compared between 2 groups.The factors related to no-reflow/slow flow were analyzed by using multi-factor Logistic regression analysis in AMI patients after PCI.The predictive value of related factors to no-reflow/slow flow was analyzed by using ROC curve.Results The results of single-factor Logistic regression analysis showed that age,blood sugar,systolic blood pressure(SBP),disease onset time to PCI,heart rate(HR),modified shock index(MSI),D-dimer(D-D)and monocyte/high-density lipoprotein-cholesterol ratio(MHR)were correlated to no-reflow/slow flow in AMI patients after PCI(P<0.05).The results of multi-factor Logistic regression analysis showed that blood sugar(OR=2.888,95%CI:1.274~6.547),disease onset time to PCI(OR=3.881,95%CI:1.625~9.270),MSI(OR=54.341,95%CI:10.178~290.127),D-D(OR=35.801,95%CI:7.021~182.558)and MHR(OR=2.048,95%CI:1.502~2.795)were independent risk factors for no-reflow/slow flow in AMI patients after PCI(P<0.05).The results of ROC curve analysis showed that above risk factors had some predictive value to no-reflow/slow flow in AMI patients after PCI.Conclusion Blood sugar,disease onset time to PCI,MSI,D-D and MHR are correlated to no-reflow/slow flow in AMI patients after PCI,and have some predictive value.

关 键 词：急性心肌梗死 经皮冠状动脉介入治疗 无复流/慢血流 

分 类 号：R542.22[医药卫生—心血管疾病]