摘要
目的:分析急性ST段抬高型心肌梗死(STEMI)经皮冠状动脉介入治疗(PCI)后患者发生心肌微循环灌注障碍的影响因素。方法:回顾性分析2020年1月至2023年1月该院收治的187例STEMI患者的临床资料,所有患者均进行PCI治疗,统计STEMI患者PCI术后心肌微循环灌注障碍发生情况,采用Logistic回归分析STEMI患者PCI术后发生心肌微循环灌注障碍的影响因素。结果:STEMI患者PCI术后发生心肌微循环灌注障碍37例,设为发生组,未发生心肌微循环灌注障碍150例,设为未发生组;发生组年龄≥60岁、合并糖尿病、术后TIMI血流分级低占比,以及血清钙离子依赖C型凝集素样受体-2(CLEC-2)水平均高于未发生组,症状至首次医疗接触(FMC)时间、FMC至肝素给予(FMC-H)时间长于未发生组,差异有统计学意义(P<0.05);经Logistic回归分析结果显示,年龄≥60岁、合并糖尿病、术后TIMI血流分级低、FMC时间延长、FMC-H时间延长、CLEC-2高水平均为影响STEMI患者PCI术后发生心肌微循环灌注障碍的独立危险因素(OR>1,P<0.05)。结论:年龄≥60岁、合并糖尿病、术后TIMI血流分级低、FMC时间延长、FMC-H时间延长、CLEC-2高水平均为影响STEMI患者PCI术后发生心肌微循环灌注障碍的危险因素。
Objective:To analyze influencing factors of myocardial microcirculation perfusion disorder in patients with acute ST-segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods:The clinical data of 187 patients with STEMI admitted to this hospital from January 2020 to January 2023 were retrospectively analyzed.All patients were treated with PCI.The incidence of myocardial microcirculation perfusion disorder after PCI in these STEMI patients was statistically analyzed.Logistic regression was used to analyze the influencing factors of myocardial microcirculation perfusion disorder after PCI in the STEMI patients.Results:There were 37 cases of myocardial microcirculation perfusion disorder in the STEMI patients after PCI,which were set as the occurrence group,and 150 cases without myocardial microcirculation perfusion disorder were set as the non-occurrence group.The proportions of the patients with age Myocardial microcirculation perfusion disorder 60 years old,combined diabetes mellitus,postoperative low TIMI blood flow grade and the CLEC-2 level in the occurrence group were higher than those in the non-occurrence group,the FMC and FMC-H were longer than those in the non-occurrence group,and the differences were statistically significant(P<0.05).Logistic regression analysis showed that age≥60 years old,combined diabetes mellitus,postoperative low TIMI blood flow grade,prolonged FMC time,prolonged FMC-H time,and high level of CLEC-2 were all risk factors for myocardial microcirculation perfusion disorders in the STEMI patients after PCI(OR>1,P<0.05).Conclusions:Age≥60 years old,combined diabetes mellitus,postoperative low TIMI blood low grade,prolonged FMC time,prolonged FMC-H time and high level of CLEC-2 are the risk factors for myocardial microcirculation perfusion disorder in the STEMI patients after PCI.
作者
刘自良
LIU Ziliang(Department of Cardiology of Wugang People’s Hospital,Pingdingshan 462500 Henan,China)
出处
《中国民康医学》
2023年第20期1-4,共4页
Medical Journal of Chinese People’s Health
关键词
经皮冠状动脉介入治疗
急性ST段抬高型心肌梗死
心肌微循环灌注障碍
影响因素
Percutaneous coronary intervention
Acute ST-segment elevation myocardial infarction
Myocardial microcirculation perfusion disorder
Influencing factor
