摘要
目的:探讨急性心肌梗死(AMI)患者接受急诊经皮冠状动脉介入治疗(PCI)术后慢血流-无再流现象与入院血糖水平之间的关系。方法:930例首次发生急性心肌梗死患者,根据患者入院血糖的四分位数6．9,8．5,10．2 mmol／L分为Q1组(n= 232),Q2组(n=238),Q3组(n=229)及Q4组(n=231)4组,分析急诊PCI中慢血流-无再流发生的危险因素。结果:930例患者中82例发生慢血流-无再流,发生率为8．8％。随着入院血糖水平的升高,慢血流(从Q1组= 2．2％到Q4组=10．4％)、无再流(从Q1组=2．2％到Q4组=6．5％)、糖尿病(从Q1组=10．8％到Q4组=53.7％)、Killip分级≥Ⅱ级(从Q1组=6．7％到Q4组=26．4％)的发生率增加,有显著性差异,并呈线性趋势(P<0．01)。血糖水平与年龄(r=0．48,P<0．05)及血清肌酸激酶MB同工酶峰值呈正相关(r=0．59,P<0．05)。入院血糖水平、缺乏梗死前心绞痛、急诊PCI术前0级血流及Killip分级≥Ⅱ级是慢血流-无再流发生的预测因素。随着血糖的增高,发生慢血流-无再流的危险性增大。结论:入院血糖水平是急诊PCI术中慢血流-无再流发生的独立预测因素。
Objective： To analyse the relation between serum glucose concentration and slow-no-reflow phenomenon in patients with acute myocardial infarction （AMI）.
Methods： A total of 930 patients with first AMI onset undergoing emergent percutaneous coronary intervention （PCI） were stratified into quartile groups （Q1 to Q4） defined by serum glucose concentrations of 6. 9, 8.5, and 10. 2 mmol/L. The relation between quartile group and slow-no-reflow phenomenon during PC1 procedure was analysed.
Results： The slow-no-reflow phenomenon was found in 82 （8. 8% ） of 930 patients. The proportion of patients with slowflow （from 2. 2% in Q1 to 10. 4% in Q4[P 〈0. 05] ）and no-reflow （from 2. 2% in Q1 to 6.5% in Q4[P 〈0. 05] ） increased across the quartile groups. The trend tot frequency of DM（from 10. 8% in Q1 to 53.7% in Q4[P 〈0. 05] ）, Killip classy〉 Ⅱ（from6.7% in Q1 to 26. 4% in Q4[P〈0.05]） was similar. The peak CK-MB （r=0.59,P〈0.05）and age（r=0.48,P〈 0. 05） had a linear associations with serum glucose concentration. The blood glucose level was an independent prognostic factor for no-reflow, along with Killip classy〉 Ⅱ ,TIMI flow =0 on initial angiogram and absence of pre-infarction angina. The odds of no-reflow increased incrementally across the quartile groups.
Conclusion： Blood glucose level was an independent prognostic factor for slow-no-reflow.
出处
《中国循环杂志》
CSCD
北大核心
2006年第4期249-252,共4页
Chinese Circulation Journal
基金
本研究得到军队医学科学十五攻关重点课题(012001)资金资助
关键词
心肌梗塞
慢血流
无再流
高糖血症
Myocardial infarction
Slow-flow
No-reflow
Hyperglycemia
