ST段抬高型心肌梗死患者行经皮冠状动脉介入术后左心房室耦合指数相关影响因素分析  

Analysis of factors influencing the left atrioventricular coupling index in patients with ST-segment elevation myocardial infarction after percutaneous coronary intervention

作　　者：白新波 张哲 鲍雪 康丽娜[1] 徐标[1] BAI Xin-bo;ZHANG Zhe;BAO Xue;KANG Li-na;XU Biao(Department of Cardiology,Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210008,China;Department of Cardiology,Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院心血管内科,江苏省南京市210008 [2]南京医科大学鼓楼临床医学院心血管内科

出　　处：《中国心血管病研究》2024年第12期1068-1073,共6页Chinese Journal of Cardiovascular Research

基　　金：江苏省医学重点学科项目(ZDXK202208)。

摘　　要：目的探讨ST段抬高型心肌梗死(STEMI)患者行经皮冠状动脉介入术(PCI)后左心房室耦合指数(LACI)的相关影响因素。方法纳入2018年9月至2022年8月在南京鼓楼医院心血管内科行PCI并住院的452例STEMI患者,根据纳排标准,最终纳入346例患者。收集患者的临床资料、术前实验室检查、冠状动脉造影数据以及术后心脏核磁共振(CMR)检查结果。根据CMR结果计算出LACI,以LACI中位数26.61(21.12,34.90)%为界将患者分为高LACI组(n=173)和低LACI组(n=173)。采用单因素及多因素logistic回归分析影响STEMI患者行PCI术后LACI的相关因素。结果单因素logistic回归分析显示,年龄、高血压与LACI增大风险升高相关(P<0.05)。男性、吸烟、血红蛋白升高、淋巴细胞计数升高、总胆固醇浓度、低密度胆固醇浓度升高与LACI增大风险降低相关(P<0.05)。校正混杂因素后,多因素logistic回归分析显示,高血压(OR=1.593,95%CI 1.015~2.502)与LACI增大风险升高相关(P<0.05)。血红蛋白升高(OR=0.983,95%CI 0.966~0.999)与LACI增大风险降低相关(P<0.05)。结论高血压、术前血红蛋白降低与STEMI患者PCI术后LACI增大风险升高独立相关。Objective To explore the factors that impact the left atrioventricular coupling index(LACI)after percutaneous coronary intervention(PCI)in patients suffering from ST-segment elevation myocardial infarction(STEMI).Methods Patients diagnosed with STEMI who underwent PCI and were admitted to the Cardiology Department of Nanjing Drum Tower Hospital between September 2018 and August 2022,totaling 346 patients of the 452 individuals,based on the exclusion criteria,were finally included.The clinical data,preoperative laboratory tests,coronary angiography data and postoperative cardiac magnetic resonance(CMR)results were collected.The LACI was calculated based on the CMR results,and the patients were divided into the high LACI group(n=173)and the low LACI group(n=173)using the median LACI 26.61(21.12,34.90)%as the boundary.Univariate and multivariate logistic regression analysis were used to analyze the factors associated with LACI after PCI in the patients.Results Univariate logistic regression analysis showed that age,hypertension were associated with the increased risk of increased LACI(P<0.05).Male,smoking,higher hemoglobin,higher lymphocyte counts,higher total cholesterol concentrations and higher low density lipoprotein cholesterol concentrations were associated with a decreased risk of increased LACI(P<0.05).Upon adjusting for confounding variables,multifactorial logistic regression analysis demonstrated that hypertension(OR=1.593,95%CI 1.015-2.502)was linked to an increased risk of elevated LACI(P<0.05).Conversely,an elevated hemoglobin(OR=0.983,95%CI 0.966-0.999)was associated with a decreased risk of increased LACI(P<0.05).Conclusion Hypertension and lower preoperative hemoglobin are independently associated with a higher risk of increased LACI after PCI in STEMI patients.

关 键 词：左房室耦合指数 ST段抬高型心肌梗死 心脏核磁共振 相关因素 

分 类 号：R542.22[医药卫生—心血管疾病]