摘要
目的确定非ST段抬高心肌梗死患者MAPH评分和经皮冠状动脉介入治疗后TIMI血流之间的关系。方法收集2023年1月—12月在本院急诊科首次接受直接经皮冠状动脉介入治疗的172例非ST段抬高型心肌梗死患者。根据PCI术后TIMI血流评分,将患者分为无复流组25例和正常血流组147例。比较两组患者一般资料、实验室指标、MAPH评分及高切变率(HSR)和低切变率(LSR)。结果两组患者相比,无复流组患者有较高的MAPH评分,多因素回归分析显示,MAPH评分>1.5分(OR:0.259;95%CI:0.123~0.546,P<0.01)是非ST段抬高心肌梗死患者经皮冠状动脉介入治疗后TIMI血流的独立预测因素。MAPH评分预测非ST段抬高心肌梗死患者经皮冠状动脉介入治疗后存在低TIMI冠状动脉血流,其敏感性为77.3%,特异性为49.3%(AUC:0.785,95%CI:0.698~0.871,P=0.000)。受试者工作特征(ROC)曲线成对比较结果显示,MAPH评分在预测较高血栓负荷方面优于其他自身参数以及HSR和LSR。结论MAPH评分是非ST段抬高心肌梗死患者PCI术后冠状动脉无复流的预测指标。
Objective To determine the relationship between MAPH score and TIMI blood flow after percutaneous coronary intervention in patients with N-STEMI.Methods A total of 172 patients with N-STEMI who received direct percutaneous coronary intervention for the first time in the emergency department of our hospital from January 2023 to December 2023 were collected.According to the TIMI blood flow score after PCI,patients were divided into a non reflow group(n=25)and a normal blood flow group(n=147).Compared the general information,laboratory indicators,MAPH scores,and high shear rate(HSR)and low shear rate(LSR)between the two groups.Results Compared with the two groups,the non reflow group had a higher MAPH score.Multivariate regression analysis showed that a MAPH score>1.5(OR:0.259;95%CI:0.123-0.546,P<0.01)was an independent predictor of TIMI blood flow in non ST segment elevation myocardial infarction patients after percutaneous coronary intervention.The MAPH score predictd low TIMI coronary blood flow in patients with non ST segment elevation myocardial infarction after percutaneous coronary intervention,with a sensitivity of 77.3%and specificity of 49.3%(AUC:0.785,95%CI:0.698~0.871,P=0.000).Paired comparison of receiver operating characteristic(ROC)curves showd that the MAPH score was superior to other self parameters,as well as HSR and LSR in predicting higher thrombus burden.Conclusion MAPH score is a predictive indicator of no coronary artery reflow after PCI in patients with N-STEMI.
作者
秦立超
陈凤英
QIN Lichao;CHEN Fengying(Department of Emergency Medicine,The Affiliated Hospital of Inner Mongolia Medical University,Hohhot 010110,China)
出处
《西部医学》
2025年第9期1343-1347,共5页
Medical Journal of West China
基金
内蒙古自治区自然科学基金项目(2019MS08022)。
