摘要
目的探究血清脂蛋白a[Lp(a)]与急性心肌梗死(acute myocardial infarction,AMI)急诊经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)发生冠状动脉慢血流(coronary slow flow,CSF)现象及短期预后的关系。方法收集2017年1月~2019年1月在华北理工大学附属医院心内科因AMI行急诊PCI的192例患者,其中男性153例,女性39例。收集患者一般资料,包括性别、年龄、身高体重、吸烟饮酒史、糖尿病及高血压病史,抽取静脉血行生化系列和凝血系列。依据PCI中冠脉血流情况将患者分为CSF组(慢血流组)(n=39)和无CSF组(无慢血流组)(n=153)。观察患者住院期间发生主要心血管事件(MACE),包括死亡、再梗死、心力衰竭、心律失常、心肌梗死后心绞痛发作,根据是否发生MACE分为MACE组(n=39)和无MACE组(n=153);比较两组患者的各个指标。结果CSF组与无SCF组比较,再灌注时间延长,总胆固醇水平升高,差异有统计学意义;二元Logistic回归分析显示再灌注时间、Lp(a)与CSF发生独立相关;MACE组与无MACE组比较,年龄、白细胞及中性粒细胞升高,差异有统计学意义;多因素分析显示年龄、白细胞水平与MACE事件独立相关;Lp(a)≥300mg/L组左室内径高于Lp(a)<300mg/L组,差异有统计学意义。结论Lp(a)水平与急性心肌梗死介入治疗慢血流发生未见明显关联;再灌注时间是AMI急诊PCI发生CSF独立危险因素;年龄、白细胞水平是急性心肌梗死介入治疗术后MACE事件的独立危险因素;Lp(a)水平升高与AMI后1周时左室内径增加密切相关。
Objective To investigate the relationship between serum lipoprotein a[Lp(a)]and coronary slow flow(coronary slow flow CSF)phenomenon and short-term prognosis in patients with acute myocardial infarction(AMI)who underwent emergency percutaneous coronary intervention(PCI).Methods A total of 192 patients who underwent emergency interventional therapy for AMI in hospital from January 2017 to January 2019 were collected,including 153 males and 39 females.General data of patients were collected,including sex,age,height and weight,history of smoking and drinking,previous history of diabetes and hypertension,biochemical items and blood coagulation series at admission.According to the blood flow during the operation,the patients were divided into CSF group(n=39)and non-CSF group(n=153).Major cardiovascular events(MACE)were observed during hospitalization,including death,reinfarction,heart failure,arrhythmia and angina pectoris after myocardial infarction.According to whether MACE occurs or not,the patients were divided into MACE group(n=39)and non-MACE group(n=153).The indexes were compared between the two groups.Results The levels of TC and reperfusion time in the CSF group were significantly higher than those in the control group,and the difference was statistically significant.Binary Logistic regression analysis showed that the reperfusion time was independently correlated with CSF.The age,WBC and NEU levels in the MACE group were higher than those in the non-MACE group,and the difference was statistically significant.Multivariate analysis showed that age and WBC level were independently correlated with mace events;The left ventricular diameter in Lp(a)≥300mg/L group was significantly higher than that in Lp(a)<300mg/L group,the difference was statistically significant.Conclusion There is no significant correlation between Lp(a)and CSF.The reperfusion time is independently related to the occurrence of CSF in AMI emergency PCI.Age and WBC are independent influencing factors of MACE events after AMI.The concentration of
作者
赵红
崔灿
李成博
潘红梅
ZHAO Hong;CUI Can;LI Chengbo(Department of Cardiovascular Medicine,North China University of Science and Technology Affiliated Hospital,Tangshan 063000,China)
出处
《华北理工大学学报（医学版）》
2021年第5期347-353,358,共8页
Journal of North China University of Science and Technology：Health Sciences Edition
基金
河北省2020年度医学科学研究课题(编号:20201236)。
关键词
脂蛋白A
急性心肌梗死
冠状动脉慢血流
短期预后
Lipoprotein a
Acute myocardial infarction
Slow coronary blood flow
Short-term prognosis
