摘要
目的分析老年急性心肌梗死(AMI)接受直接冠状动脉介入治疗(PPCI)患者术中支架置入后出现慢血流的影响因素。方法入选2008年1月～2010年12月因AMI住院行PPCI术,年龄≥60岁的患者774例,根据术中是否出现慢血流分为慢血流组243例和对照组531例,比较2组临床特点,分析影响术中出现慢血流的危险因素。结果慢血流组患者糖尿病、血栓积分、术前TIMI血流0级比例、冠状动脉内应用替罗非班率、手术操作时间、发病至就诊时间、C反应蛋白、肌钙蛋白Ⅰ峰值及院内病死率均明显高于对照组(P<0.05),而直接支架置入率及LVEF明显低于对照组(P<0.05)。logistic回归分析显示,糖尿病、术前TIMI血流0级、C反应蛋白、发病至就诊时间、血栓积分是PPCI术中出现慢血流的独立影响因素。结论多种因素导致PPCI术中慢血流的发生,直接影响了患者的预后,应尽早识别这些高危患者,采取有效措施,改善预后。
Objective To analyze the factors influencing slow flow in elderly acute myocardial in- farction（AMI）patients undergoing primary percutaneous coronary intervention（PPCI）after stent- ing. Methods A total of 774 AMI patients aged ≥60 years,admitted to our hospital for PPCI from January 2008 to December 2010, were included in this study and divided into slow flow group （n= 243） and control group（n= 531）according to their intra-operative slow flow. Clinical charac- teristics of the patients in two groups were compared and factors influencing slow flow were ana- lyzed. Results The scores of diabetes mellitus （DM）and thrombi, grade 0 preoperative TIMI flow,tirofiban dose used in coronary artery,C-reactive protein （CRP） and troponin I level, and hospital mortality were significantly higher in slow flow group than in control group（P〈0.05）. The operation time and the time from onset of the disease to the visit of hospital were significant- ly longer while the primary stenting and LVEF rates were significantly lower in slow flow group than in control group（P〈0.05）. Logistic regression analysis showed that the scores of DM and thrombi, grade 0 preoperative TIMI flow,CRP level, and time from onset of the disease to the visit of hospital were the independent factors for slow flow in AMI patients undergoing PPCI. Conclu- sion A number of factors can lead to slow flow in AMI patients undergoing PPCI and affect their prognosis,thus such high risky patients should be recognized as early as possible and effective measures should be taken to improve their prognosis.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2012年第9期900-902,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
心肌梗死
冠状血管造影术
血流速度
C反应蛋白质
危险因素
支架
myocardial infarction
coronary angiography
biood flow velocity
C-reactive protein
risk factors
stents
