急性下壁心肌梗死患者经皮冠状动脉介入治疗术中发生无复流的相关危险因素

摘要

目的:探讨急性下壁心肌梗死患者行经皮冠状动脉介入治疗(percutaneous coronaryintervention,PCI)术中无复流的发生情况及其危险因素.方法:收集2011-12～2015-08本院急诊科收治的急性下壁心肌梗死行急诊PCI治疗患者126例,采用Logistic回归分析无复流发生的相关危险因素.结果:本研究纳入的126例急性下壁心肌梗死患者均成功进行急诊PCI治疗,其中16例发生无复流,发生率为12.70％.多因素Logistic回归分析结果显示,急性下壁心肌梗死患者急诊PCI术中出现无复流的危险因素为糖尿病(OR=1.647,95％CI:1.242～1.845,P＜0.05)、发病至急诊PCI时间(OR=5.281,95％CI:2.782～10.018,P＜0.01)、术前TIMI血流分级(≤1级)(OR=2.735,95％CI:1.040～3.062,P＜0.05)和术前收缩压(OR=1.844,95％CI:1.153～3.638,P＜0.05).结论:无复流在急性下壁心肌梗死患者急诊PCI术中具有较高的发生率,应对无复流发生的相关危险因素采取有效的预防措施,从而降低PCI术中出现无复流的风险.%Objective:To investigate the risk factors of no-reflow during percutaneous coronary intervention (PCI) in patients with acute inferior myocardial infarction.Methods:A total of 126 patients treated with PCI in our hospital were prospectively collected from December 2011 to August 2015.Risk factors of no-reflow was analyzed.Results:In the 126 patients,16 cases developed no-reflow (the incidence was 12.70％).Logistic regression analysis showed that risk factors of no-reflow included diabetes(OR=1.647,95％CI:1.242-1.845,P＜0.05),reperfusion time(OR=5.281,95 ％ CI:2.782-10.018,P ＜0.01),TIMI flow grade before primary PCI(OR=2.735,95 ％CI:1.040-3.062,P ＜0.05) and low systolic blood pressure(OR=1.844,95 ％ CI:1.153-3.638,P ＜ 0.05).Conclusion:The prevalence of no-reflow is high in acute inferior myocardial infarction patients.The change of risk factors in acute inferior myocardial infarction patients leads to reallocate in different risk stratification of no-reflow,which reminds that patients and medical staff should adhere to strengthen long-term secondary prevention interventions to improve the quality of life of patients.