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目的:探讨急性下壁心肌梗死患者急诊经皮冠状动脉介入治疗(PCI)中出现无复流的相关危险因素。方法:回顾性分析我院2014-02-2016-01行急诊PCI的急性下壁心肌梗死患者的临床基本资料及造影和介入治疗的资料,进行统计分析。结果:急性下壁心肌梗死行急诊PCI术,术中无复流发生率约12.5%。多元回归分析显示:梗死相关动脉为分叉病变(OR=1.62,95%CI 1.420~1.862,P=0.002)、再灌注时间(>6h)(OR=1.558,95%CI1.359~1.793,P=0.001)、入院时收缩压水平(<90mmHg)(OR=1.267,95%CI 1.140~1.381,P=0.004)、术前TIMI血流<1级(OR=1.080,95%CI 1.052~1.142,P<0.001)、血栓负荷程度(OR=1.580,95%CI1.468~2.646,P=0.028)和病变血管长度(OR=1.936,95%CI1.886~1.992,P=0.017)是预测术中是否出现无复流现象的独立因素。结论:急性下壁心肌梗死行急诊PCI术,术中无复流发生率约12.5%。梗死相关动脉是否为分叉病变、再灌注时间(>6h)、入院时收缩压水平(<90mmHg)、术前TIMI血流<1级、血栓负荷程度和病变血管长度等因素可预测术中是否出现无复流现象。
Objective: To explore the related risk factors of no-reflow in emergency percutaneous coronary intervention (PCI) in patients with acute inferior myocardial infarction. Methods: The clinical data of patients with acute inferior myocardial infarction who underwent emergency PCI during 2014-02-2016-01 in our hospital were analyzed retrospectively. The data of contrast and interventional therapy were analyzed retrospectively. Results: Acute inferior myocardial infarction underwent emergency PCI and no intraoperative recurrence rate was 12.5%. Multivariate regression analysis showed that the infarct-related arteries were bifurcated lesions (OR = 1.62, 95% CI 1.420-1.862, P = 0.002) and reperfusion time (OR = 1.267, 95% CI 1.140-1.381, P = 0.004), preoperative TIMI blood flow <1 grade (OR = 1.080, 95% CI 1.052-1.1421, (OR = 1.580, 95% CI 1.468-2.646, P = 0.028) and pathological vessel length (OR = 1.936, 95% CI 1.886-1.992, P = 0.017) Whether there is an independent factor of no-reflow phenomenon. Conclusion: The emergency PCI of acute inferior myocardial infarction is performed. The incidence of no-reflow during operation is about 12.5%. Infarct-related arteries were bifurcated lesions, the duration of reperfusion (> 6 h), admission systolic blood pressure (<90mmHg), preoperative TIMI flow <1, thrombus burden and lesion vessel length could predict whether intraoperative There is no reflow phenomenon.