微循环阻力指数联合左室舒张末期压力指数预测急性心肌梗死患者预后的价值

The value of microcirculation resistance index combined with left ventricular end-diastolic pressure index in predicting the prognosis of patients with acute myocardial infarction

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中文摘要：目的:探讨急性ST段抬高型心肌梗死(STEMI)患者中联合测量微血管阻力指数(IMR)和左室舒张末期压力(LVEDP)对介入治疗(PCI)患者预后的价值.方法:选取2019 年3 月～2021 年10 月深圳市人民医院收治的STEMI患者73例,行急诊血运重建治疗.在直接PCI结束时进行IMR和LVEDP 测量,根据结果分为低LVEDP/低IMR组(n=24),高LV-EDP/低IMR组(n=14),低LVEDP/高IMR组(n=19),高LVEDP/高IMR组(n=16).对术后住院期间及术后 3 个月时的心脏功能指标、随访起病之后1 年时主要不良心脏事件(MACE)进行统计学分析.结果:入选STEMI患者均成功行再灌注治疗,术后TIMI血流均为Ⅲ级.四组比较,运重建治疗之后住院期间EF值比较差异无统计学意义(P>0.05).血运重建治疗之后3 个月,高LVEDP/高IMR组EF值低于其他组,差异有统计学意义(P<0.05),而其他三组之间EF值比较差异无统计学意义(P>0.05);术后及术后 3 个月,高LVEDP/高IMR组NT-proBNP值均高于其他组,差异有统计学意义(P<0.05),其他三组之间NT-proBNP值比较差异无统计学意义(P>0.05).1 年随访MACE发生率,高LVEDP/高IMR组的发生率显著升高,与其他三组比较,差异有统计学意义(P<0.05).结论:IMR联合LVEDP可以明显提高对STEMI患者直接经皮冠状动脉介入治疗预后的预测价值.

外文摘要：Objective To investigate the value of combined measurement of microvascular resistance index(IMR)and left ventric-ular end-diastolic pressure(LVEDP)in patients with acute ST-segment elevation myocardial infarction(STEMI)in prognosis of pa-tients after interventional therapy.Method 73 STEMI patients admitted to Shenzhen People's Hospital from March 2019 to October 2021 weie selected for emergency revascularization.IMR and LVEDP were measured at the end of primary PCI,and they were divided into low LVEDP/low IMR group(n=24),high LVEDP/low IMR group(n=14),low LVEDP/high IMR group(n=19),high LV-EDP/high IMR group(n=16)according to the results.Cardiac function indicators during postoperative hospitalization and 3 months after surgery,and MACE events at 1 year after the onset of follow-up were statistically analyzed.Results All patients were successfully treated with reperfusion,and the postoperative TIMI blood flow was all grade Ⅲ.Comparing the four groups,there was no difference in EF values during hospitalization after reconstruction therapy(P>0.05).At 3 months after revascularization,the EF value of the high LVEDP/high IMR group was lower than that of the other groups(P<0.05),while there was no statistical difference in the EF value between the other three groups(P>0.05).The NT-proBNP values in the high LVEDP/high IMR group were higher than those in the other groups(P<0.05),and there was no statistical difference in the NT-proBNP values among the other three groups(P>0.05).In the 1-year follow-up,the incidence of MACE events was significantly higher in the high LVEDP/high IMR group,which was signifi-cantly different from the other three groups(P<0.05).Conclusion IMR combined with LVEDP can significantly improve the predic-tive value of direct percutaneous coronary intervention in STEMI patients.

外文关键词：

Acute ST-segment elevation myocardial infarctionMicrovascular resistance indexLeft ventricular end-diastolic pressureCoronary interventionPrognosis

作者：

刘启云、李江华、刘华东、尹达、罗林杰

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作者单位：

深圳市人民医院暨南大学第二临床医学院南方科技大学第一附属医院心内科深圳市心血管微创医学工程技术研究开发中心,广东深圳 518020

关键词：

急性ST段抬高型心肌梗死微血管阻力指数左室舒张末期压力冠状动脉介入治疗预后

基金：

深圳市医疗卫生三名工程项目资助深圳市医学重点学科建设经费资助项目

项目编号：

SZSM201412012SZXK003

出版年：

2024

DOI：

10.3969/j.issn.1004-0412.2024.09.013

吉林医学

吉林省人民医院

吉林医学

影响因子：0.926

ISSN：1004-0412

年,卷(期)：2024.45(9)