摘要
目的分析经皮冠状动脉介入治疗(PCI)后冠状动脉无复流现象发生的危险因素和预后。方法回顾性分析因急性冠状动脉综合征入我院行PCI治疗的患者524例中有较完整随访资料的427例,PCI支架置入即刻在无影响血流的血栓、栓塞、夹层、痉挛情况下,冠状动脉造影前向血流TIMI≤2级为无复流,TIMI 3级为正常血流。利用Excel随机函数表,从393例急诊PCI冠状动脉前向血流恢复正常的患者中随机抽取70例,为对照组。结果冠状动脉无复流患者34例,无复流组心肌梗死和糖尿病比例明显高于对照组,且胰岛素水平、白细胞总数和中性粒细胞总数也明显高于对照组。院内和院外不良事件发生率无复流组明显高于对照组,左心室射血分数较前明显减低,而左心室舒张末内径较前明显增大。结论无复流受既往糖尿病、胰岛素及白细胞水平的影响,可使住院期间和院外不良事件明显增加,是心肌继续缺血、心室重构和心功能恢复障碍的预测因子,也是心肌和微血管损伤的标志。
Objective To investigate the risk factors and prognosis of no-reflow phenomenon in patients after pereutaneous coronary intervention （PCI）. Methods Retrospectively analyzed 524 patients with acute coronary syndrome after PCI of which 427 patients had detailed record. Angiographic no-reflow phenomenon was designated as TIMI≤2 flow without mechanical obstruction of embolism, thrombus, dissection and spasm. Normal flow designated as TIMI 3 flow. Using random count table of Excel, 70 patients were randomized from 393 patients with coronary flow TIMI 3 after PCI as the control normal flow group. Results The no reflow group enrolled 34 patients. Compared with the normal flow group, their incidence of AMI and diabetes, the blood insulin level and mean leukocyte count were significantly higher. The incidence of MACE in and out of hospital was higher in the no reflow group than the normal flow group. Within the no reflow group, the EF decreased while the LVEDD increased significantly PCI. Conduslon History of diabetes, blood insulin levd and leukocyte count may be the risk factors of no-reflow. On the other hand, the no reflow phenomenon maybe a prognostic factor of MACE, ventricular remodeling and heart function for patients after PCI. Prognosis
出处
《中国介入心脏病学杂志》
2006年第1期34-36,共3页
Chinese Journal of Interventional Cardiology
