影响急性心肌梗死患者急诊经皮冠状动脉介入术后血流的相关因素分析
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Analysis of Related Factors Affecting Blood Flow After Primary Percutaneous Coronary Intervention in Patients with Acute Myocardial Infarction
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    摘要:

    目的探讨影响急性心肌梗死患者急诊经皮冠状动脉介入治疗术后血流(心肌梗死血栓溶解后血流)的相关因素。方法收集行急诊经皮冠状动脉介入治疗术后的急性心肌梗死患者的临床和造影资料,应用单变量和多变量逻辑回归的方法,分析可能影响急诊经皮冠状动脉介入治疗术后心肌梗死血栓溶解后血流的临床和介入操作的相关因素。结果共入选75例行急诊经皮冠状动脉介入治疗术的急性心肌梗死患者,其中心肌梗死血栓溶解后血流3级者60例(占80%),心肌梗死血栓溶解后血流≤2级者15例(占20%)。单变量分析表明梗死相关血管直径、球囊扩张次数、置入支架数量和直径、支架内扩张次数、有无糖尿病史、症状发作至急诊室就诊时间、症状发作至导管室时间、症状发作至血流开放时间可明显影响急诊经皮冠状动脉介入治疗术后心肌梗死血栓溶解后血流(P均<0.05);多变量分析表明梗死相关血管直径、球囊扩张次数、有无糖尿病史、症状发作至急诊室就诊时间可独立影响急诊经皮冠状动脉介入治疗术后心肌梗死血栓溶解后血流(P均<0.05)。结论梗死相关血管直径、球囊和支架扩张次数、有无糖尿病史、症状发作至血流恢复时间可影响急性心肌梗死患者急诊经皮冠状动脉介入治疗术后心肌梗死血栓溶解后血流。

    Abstract:

    Aim To evaluate the related factors that affect thrombolysis in myocardial infarction(TIMI) flow after primary percutaneous coronary intervention(PCI) in patients with acute myocardial infarction(AMI). Methods Clinical and angiographic data of AMI patients treated by primary PCI were collected.Relative analysis was completed. Results 75 AMI patients treated by primary PCI were included in the study,60 patients had TIMI 3 flow(60/75,80%),and 15 patients had less than TIMI 3 flow(15/75,20%).Univariate analysis showed that the infarct related artery diameter,times of balloon dilation,stent number, stent diameter,times of stent dilation,history of diabetes mellitus,time from symptom onset to emergency room,catheterization room and flow reopened could affect TIMI flow obviously(p<0.05),multivariate analysis showed that the infarct related artery diameter,times of balloon dilation,history of diabetes mellitus,time from symptom onset to emergency room were independent factors which influenced TIMI flow after primary PCI(p<0.05). Conclusions The infarct related artery diameter,times of balloon and stent dilation,history of diabetes mellitus,time from symptom onset to flow reopened were independent factors which influenced TIMI flow after primary percutaneous coronary intervention in patients with acute myocardial infarction.

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陈小芳,徐标,宋杰,王涟,张荣林,施广飞.影响急性心肌梗死患者急诊经皮冠状动脉介入术后血流的相关因素分析[J].中国动脉硬化杂志,2006,14(6):535~537.

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  • 收稿日期:2005-10-08
  • 最后修改日期:2006-04-19
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