前壁心梗患者微循环功能障碍的影响因素及预测模型的建立  

The influencing factors of microcirculation dysfunction in patients with anterior wall acute myocardial infarction and the establishment of prediction model

作　　者：张宇杰 王迪 叶添宝 刘亮[1] 金贤 沈成兴 ZHANG Yujie;WANG Di;YE Tianbao;LIU Liang;JIN Xian;SHEN Chengxing(Affiliated Shanghai Sixth People's Hospital.School of Medicine,Shanghai JiaoTong University,Shanghai 200233,China)

机构地区：[1]上海交通大学医学院附属第六人民医院,上海200233 [2]上海交通大学医学院附属第一人民医院

出　　处：《介入放射学杂志》2024年第11期1181-1185,共5页Journal of Interventional Radiology

摘　　要：目的探讨急性心梗后微循环障碍患者的影响因素并建立相关预测模型。方法纳入2017年1月至2020年9月在上海市第六人民医院行PCI治疗后使用caIMR评估微循环功能的前壁心梗患者130例,其中微循环阻力异常组52例,微循环阻力正常组78例。比较2组患者的临床资料。回归分析微循环障碍的影响因素。结果微循环阻力异常组的对比剂用量、发病-手术时间、Gensini总分和LAD Gensini评分分别为(121.92±31.37)mL、(10.51±5.12)min、(97.91±31.77)分和(69.36±13.15)分,均高于微循环阻力正常组的(109.03±28.2)mL、(4.94±2.94)min、(81.05±35.22)分和(54.45±23.48)分,差异均有统计学意义(均P<0.05)。建立了涵盖介入策略的预测模型,其准确性较常规模型更高,AUC为0.91比0.87,能较好预测心梗患者发生微循环障碍的风险。结论建立前壁心梗微循环障碍模型可以较好地区分心梗后微循环障碍的高危人群。Objective To explore the influencing factors of microcirculation dysfunction in patients with anterior wall acute myocardial infarction(AMI)and to establish a relevant prediction model.Methods A total of 130 patients with anterior wall AMI,whose microcirculation function was assessed by caIMR after receiving percutaneous coronary intervention(PCI)at Shanghai Sixth People′s Hospital of China from January 2017 to September 2020,were enrolled in this study.The patients were divided into abnormal microcirculation resistance group(n=52)and normal microcirculation resistance group(n=78).The clinical data were compared between the two groups.The regression analysis was used to analyze the influencing factors of microcirculation dysfunction.Results In the abnormal microcirculation resistance group the contrast agent consumption,the onset-to-operation time,the Gensini total score and the LAD Gensini score were(121.92±31.37)mL,(10.51±5.12)min,(97.91±31.77)points and(69.36±13.15)points respectively,which were significantly higher than(109.03±28.2)mL,(4.94±2.94)min,(81.05±35.22)points and(54.45±23.48)points respectively in the normal microcirculation resistance group,the differences in the above indexes between the two groups were statistically significant(all P<0.05).A prediction model covering interventional strategies was established,and its accuracy was higher than that of a conventional model,its AUC compared with the conventional model was 0.91 to 0.87,indicating that this model could well predict the risk of microcirculation dysfunction in patients with AMI after receiving PCI.Conclusion This prediction model can promptly identify high-risk microcirculation dysfunction patients with anterior wall AMI after receiving PCI.

关 键 词：急性心肌梗死 微循环功能障碍 caIMR 

分 类 号：R541[医药卫生—心血管疾病]