贵州医科大学学报

2015, v.40;No.182(11) 1272-1275

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急性心肌梗死患者急诊经皮冠状动脉介入术后冠脉无复流的影响因素
Influential Factors for Angiographic No Reflow Phenomenon of Coronary Artery of Patients with Acute Myocardial Infarction after Percutaneous Coronary Intervention

崔其峰;刘彬;
CUI Qifeng;LIU Bin;Emergency Department,Beijing Jiangong Hospital;

摘要(Abstract):

目的:分析急诊经皮冠状动脉介入治疗(PCI)后冠脉无复流的影响因素。方法:急诊PCI治疗的94例急性心肌梗死(AMI)患者,分为观察组(PCI术后冠脉无复流)和对照组(PCI术后冠脉灌注良好),比较两组AMI患者年龄、性别和糖尿病、高血压、吸烟、饮酒史、肌酸激酶(CPK)、肌酸激脢(CK-MB)、C-反应蛋白(CRP)及血糖、冠状动脉造影及心功能,Logistics回归分析影响急诊PCI术后冠脉无复流的独立危险因素。结果:观察组患者合并糖尿病的比例、CPK、CPK-MB水平、心肌梗塞溶栓治疗(TIMI)血流0级比例、Killip分级>Ⅰ级的比例及冠脉内血栓比例显著高于对照组,差异有统计学意义(P<0.05);logistics回归分析结果显示合并糖尿病、Killip>Ⅰ级及TIMI血流0级是影响急诊PCI术后冠脉无复流的独立危险因素(P<0.05)。结论:影响急诊PCI术后冠脉无复流的因素为糖尿病史、术前心功能及冠脉血流情况。
Objective: To analyze influential factors of angiographic no reflow phenomenon of coronary artery of patients with acute myocardial infarction( AMI) after emergent percutaneous coronary intervention( PCI). Methods: Clinical data of patients with AMI undergoing treatment of percutaneous coronary intervention in our hospital from 2008 to 2014 was retrospectively analyzed. Patients were divided into two groups,observation group( angiographic no reflow phenomenon after treatment) and control group( good coronary perfusion). The age of AMI patients,gender,diabetes mellitus,hypertension,smoking and drinking history,CPK,CK-MB,CRP,blood sugar,coronary arteriongraphy and heart function were compared between two groups. Logistical regression analysis was adopted to analyze the independent risk factors for coronary no reflow after PCI emergency surgery. Results: Observation group patients had a higher rate of combined diabetes than that of control group( χ2= 4. 504,P =0. 034). Observation group patients had higher levels of CPK and CK-MB than those of control group,the difference was statistically significant( P < 0. 001). Observation group patients had higher rate of TIMI 0 class of blood flow and Killip class > Ⅰbefore emergent PCI than these of control group( P <0. 001). Multivariate regression analysis showed that Killip class > Ⅰ,TIMI 0 class and diabetes mellitus were independent risk factors for angiographic no reflow phenomenon after primary percutaneous coronary intervention. Conclusion: Diabetes mellitus,preoperative heart function and coronary blood flow are main risk factors of the no reflow phenomenon for patient receiving treatment of PCI.

关键词(KeyWords): 经皮冠状动脉介入治疗;心肌梗死,急性;糖尿病;无复流现象
percutaneous coronary intervention;acute myocardial infarction,acute;diabetes mellitus;no reflow phenomenon

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作者(Author): 崔其峰;刘彬;
CUI Qifeng;LIU Bin;Emergency Department,Beijing Jiangong Hospital;

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DOI: 10.19367/j.cnki.1000-2707.2015.11.039

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