中国循证心血管医学杂志2024,Vol.16Issue(8) :1000-1003.DOI:10.3969/j.issn.1674-4055.2024.08.21

ST段抬高型心肌梗死患者直接PCI术后发生微血管阻塞的危险因素及其预测价值分析

Risk factors and predictive value of microvascular obstruction in patients with ST-segment elevation my-ocardial infarction after primary percutaneous coronary intervention

李晓冉 谭建 王佳丽
中国循证心血管医学杂志2024,Vol.16Issue(8) :1000-1003.DOI:10.3969/j.issn.1674-4055.2024.08.21

ST段抬高型心肌梗死患者直接PCI术后发生微血管阻塞的危险因素及其预测价值分析

Risk factors and predictive value of microvascular obstruction in patients with ST-segment elevation my-ocardial infarction after primary percutaneous coronary intervention

李晓冉 1谭建 2王佳丽1
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作者信息

  • 1. 100050 北京,首都医科大学附属北京友谊医院心血管中心
  • 2. 100027 北京,北京市疾病预防控制中心北京市预防医学科学院
  • 折叠

摘要

目的 探讨ST段抬高型心肌梗死(STEMI)患者接受直接经皮冠状动脉介入治疗(pPCI)术后发生微血管阻塞(MVO)的危险因素.方法 本研究入选2019年10月至2021年6月间于北京友谊医院心内科住院的STEMI并行pPCI患者149例作为研究对象,患者pPCI术后1周内接受心脏核磁共振(CMR)检查,根据患者术后是否发生MVO分为MVO组(n=77)及非MVO组(n=72),比较两组患者一般资料及实验室检查,包括心肌梗死定位、心肌肌钙蛋白T(cTnT)、N末端脑钠肽前体(NT-proBNP)、超敏C反应蛋白(hs-CRP)、尿素、肌酐、促甲状腺激素(TSH)、低密度脂蛋白胆固醇(LDL-C)、糖化血红蛋白(HbA1c)等,采用多因素Logistic回归分析发生MVO的危险因素.结果 cTnT峰值、hs-CRP水平MVO组高于非MVO组,差异有统计学意义(P<0.05),ROC分析显示对于STEMI患者发生MVO的预测价值,cTnT峰值及hs-CRP的ROC曲线下面积分别为0.794、0.674(P<0.05).结论 cTnT峰值及hs-CRP是STEMI患者发生MVO的独立危险因素,对MVO的发生具有一定预测价值.

Abstract

Objective To discuss the risk factors for microvascular obstruction(MVO)in patients with ST-segment elevation myocardial infarction(STEMI)after primary percutaneous coronary intervention(pPCI).Methods STEMI patients undergone pPCI(n=149)were chosen from Department of Cardiology in Beijing Friendship Hospital from Oct.2019 to June 2021.The patients were received examination of cardiac magnetic resonance(CMR)within 1 week after pPCI,and divided into MVO group(n=77)and non-MVO group(n=72)according to MVO occurrence status.The general data and results of laboratory tests,including myocardial infarction location,cardiac troponin T(cTnT),N-terminal pro-brain natriuretic peptide(NT-proBNP),high sensitivity C-reactive protein(hs-CRP),urea,creatinine(Cr),thyroid stimulating hormone(TSH),low-density lipoprotein-cholesterol(LDL-C)and glycated hemoglobin(HbAlc)were compared between 2 groups.The risk factors for MVO occurrence were analyzed by using multi-factor Logistic regression analysis.Results The peak value of cTnT and hs-CRP level were higher in MVO group than those in non-MVO group(P<0.05).The results of ROC curve analysis showed that AUC of cTnT was 0.794 and AUC of hs-CRP was 0.674 in predicting MVO in STEM patients(P<0.05).Conclusion The peak value of cTnT andhs-CRP level are independent risk factors for MVO in STEMI patients,and have a certain predictive value to MVOoccurrence.

关键词

心肌梗死/微血管阻塞/心脏磁共振/肌钙蛋白T/超敏C反应蛋白

Key words

Myocardial infarction/Microvascular obstruction/Cardiac magnetic resonance/Cardiac troponin T/High sensitivityC-reactive protein

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出版年

2024
中国循证心血管医学杂志
中国人民解放军北京军区总医院

中国循证心血管医学杂志

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影响因子:1.272
ISSN:1674-4055
参考文献量4
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