摘要
目的探讨ST段抬高型心肌梗死(ST segment elevation myocardial infarction,STEMI)患者经皮冠状动脉介入(percutaneous coronary intervention,PCI)术后心肌组织灌注情况及相关影响因素。方法回顾性分析2018年10月—2021年10月因STEMI于邹城市人民医院行PCI手术的256例患者的临床资料。根据术后心肌组织灌注情况将其分为心肌组织灌注良好组(n=154)和心肌组织灌注不良组(n=102)。比较心肌组织灌注情况,分析影响因素。结果单因素分析显示,性别、年龄、体质量、合并高血压、病变血管数量、冠状动脉是否为左前降支、血栓抽吸导管使用情况与STEMI患者PCI术后心肌组织灌注情况比较,差异无统计学意义(P>0.05);吸烟、合并糖尿病、心肌组织再灌注时间、术中复流情况与STEMI患者PCI术后心肌组织灌注情况比较,差异有统计学意义(P<0.05);经Logistic回归分析结果显示,吸烟(β=0.580,OR=1.786,95%CI=1.068~2.988)、合并糖尿病(β=0.861,OR=2.365,95%CI=1.418~3.944)、心肌组织再灌注时间(β=0.924,OR=2.519,95%CI=1.934~3.282)、术中无复流(β=1.270,OR=3.561,95%CI=2.088~6.074)均为STEMI患者PCI术后心肌组织灌注的影响因素(P<0.05)。结论STEMI患者PCI术后心肌灌注与吸烟、合并糖尿病、心肌组织再灌注时间、术中无复流等均相关,临床需加强对危险因素的重视,采取针对性预防干预措施,以改善患者预后。
Objective Explore the myocardial tissue perfusion and related influencing factors in patients with ST seg⁃ment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods Retrospective analysis of clinical data of 256 patients who underwent PCI surgery at Zoucheng People's Hospital from October 2018 to October 2021 due to STEMI.According to the postoperative myocardial tissue perfusion,they were divided into two groups:the group with good myocardial tissue perfusion(n=154)and the group with poor myocardial tissue perfusion(n=102).Compare myocardial tissue perfusion and analyze influencing factors.Results Univariate analysis showed that there was no statistically significant difference(P>0.05)in gender,age,body mass,concomitant hyper⁃tension,number of diseased vessels,whether the coronary artery is a left anterior descending branch,and the use of thrombus aspiration catheters compared to myocardial tissue perfusion after PCI in NSTEMI patients;There were sig⁃nificant differences between smoking,diabetes,myocardial tissue reperfusion time,intraoperative reflow and myocar⁃dial tissue perfusion after PCI in NSTEMI patients(P<0.05);the results of logistic regression analysis showed that smoking(β=0.580,OR=1.786,95%CI=1.068~2.988),combined with diabetes(β=0.861,OR=2.365,95%CI=1.418~3.944),myocardial tissue reperfusion time(β=0.924,OR=2.519,95%CI=1.934~3.282),no reflow during surgery(β=1.270,OR=3.561,95%CI=2.088~6.074)are all influencing factors for myocardial tissue perfusion in STEMI patients after PCI(P<0.05).Conclusion Myocardial perfusion after PCI in patients with STEMI is related to smoking,diabetes mellitus,myocardial tissue reperfusion time,and intraoperative no-reflow.It is necessary to pay more attention to risk factors and take targeted preventive interventions to improve the prognosis of patients.
作者
孙琰
宋海彬
杜宗雷
SUN Yan;SONG Haibin;DU Zonglei(Department of Cardiology,Zoucheng People's Hospital,Jining,Shandong Province,273500 China)
出处
《中外医疗》
2023年第2期28-31,41,共5页
China & Foreign Medical Treatment
关键词
ST段抬高型心肌梗死
经皮冠状动脉介入
心肌组织灌注
影响因素
ST-segment elevation myocardial infarction
Percutaneous coronary intervention
Myocardial tissue perfusion
Influencing factors
