首页|急性ST段抬高型心肌梗死患者球囊后扩张相关性无复流的危险因素分析

急性ST段抬高型心肌梗死患者球囊后扩张相关性无复流的危险因素分析

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[目的]探究急性ST段抬高型心肌梗死(STEMI)患者行急诊经皮冠状动脉介入治疗(PCI)球囊后扩张相关性无复流的危险因素及其对预后的影响.[方法]收集发病12 h内行急诊PCI术并进行球囊后扩张的STEMI患者共147例,根据TIMI血流分级分为正常血流组和无复流组.比较两组患者的基本临床资料、造影特征、术后疗效及术后1年内主要不良心血管事件(MACE)发生情况.对年龄、症状至PCI时间、罪犯病变长度、支架植入数量、血栓负荷进行回归分析,探究STEMI患者球囊后扩张相关性无复流的危险因素.并对无复流及术后1年主要不良心血管事件发生进行相关性分析,探究危险因素对预后的影响.[结果]共有16例患者发生了球囊后扩张相关性无复流,无复流发生率为10.88%.单变量分析结果提示,年龄、症状至PCI时间、罪犯病变长度、支架植入数量、血栓负荷与急诊PCI术中发生球囊后扩张相关性无复流有关(P<0.05).多变量Logistic回归模型结果显示症状至 PCI 时间延长(OR:0.95,95%CI:0.92~0.99)、罪犯病变长度增加(OR:0.96,95%CI:0.93~0.99)、血栓负荷重(OR:0.14,95%CI:0.03~0.71)可作为球囊后扩张相关性无复流的独立危险因素.[结论]症状至PCI时间延长、罪犯病变长度增加、血栓负荷重与球囊后扩张相关性无复流发生呈正相关,是球囊后扩张相关性无复流的独立危险因素.球囊后扩张相关性无复流发生率与术后1年再发心绞痛的发生率呈正相关.
Analysis of risk factors of no-reflow associated with post-stenting balloon dilatation in patients with acute ST-segment elevation myocardial infarction
Aim To identify the risk factors for no-reflow(NR)associated with post-stenting balloon dilatation(PSBD)among patients with acute ST-segment elevation myocardial infarction(STEMI)undergoing percutaneous coronary intervention(PCI)and their impact on prognosis.Methods This study enrolled 147patients with STEMI who received emergency PCI and underwent PSBD within 12 hours.The patients were divided into the normal flow group and NR group based on their TIMI thrombus scores.Clinical data,angiography characteristics,efficacy after interventional therapy,and major adverse cardiovascular events(MACE)within one year after therapy were analyzed and compared be-tween the two groups.Age,identified time to PCI,length of the offender's blood vessels,number of stent implants,and high-burden thrombus formation were analyzed to explore risk factors for NR after PSBD by regression analysis.The rela-tionship between NR and the occurrence of MACE at one year after operation was analyzed to explore the influence of risk factors on prognosis.Results Sixteen patients(10.88%)had NR after PSBD.Univariate analysis revealed the correlation of age,identified time to PCI,length of the offender's blood vessels,number of stents,and high-burden thrombus formation with the incidence of NR associated with balloon dilatation(P<0.05).Multiple Logistic analysis re-vealed that identified time to PCI(OR:0.95,95%CI:0.92~0.99),length of the offender's blood vessels(OR:0.96,95%CI:0.93~0.99)and high-burden thrombus formation(OR:0.14,95%CI:0.03~0.71)were independent risk fac-tors of NR associated with PSBD.Conclusions Prolonged time to PCI,increased length of the offender's blood ves-sels,and heavy high-burden thrombus formation are positively correlated with the occurrence of NR after PSBD,and are in-dependent risk factor of NR associated with PSBD for STEMI.The incidence of NR after PSBD was positively correlated with the incidence of recurrent angina in 1-year follow up.

ST-segment elevation myocardial infarctionpost-stenting balloon dilationno-reflow phenomenon

黄瑶、杨乐、张志、初巍巍、孙笑林、张兴

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锦州医科大学大连市第三人民医院研究生培养基地

大连市第三人民医院心内三科,辽宁省大连市 116000

急性ST段抬高型心肌梗死 球囊后扩张 无复流

大连市医学科学研究计划项目

2111006

2024

中国动脉硬化杂志
中国病理生理学会 南华大学

中国动脉硬化杂志

CSTPCD
影响因子:1.086
ISSN:1007-3949
年,卷(期):2024.32(1)
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