急性心肌梗死急诊介入后无复流的预测模型
The factors studied for prediction of coronary no-reflow in patients with STEMI after emergency coronary intervention with primary drug-eluted stenting
目的 研究急性ST段抬高型心肌梗死(ST-elevation myocardial infarction,STEMI)患者急诊药物支架置入后无复流的独立预测因素.方法 收集2007年1月至2010年3月在解放军总医院和北京朝阳医院住院,在发病后12 h内成功行急诊药物支架置入的1413例STEMI患者资料进行前瞻性分析,分为无复流组和复流正常组.采用单变量和多元logistic回归分析识别无复流的独立预测因素.结果 在1413例患者中,297例发生无复流(21.0%).多元logistic回归分析发现,年龄>65岁、再灌注时间>6h、侧支血流≤1级、入院血糖(admission plasma glucose,APG)>13.0 mmol/L、经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)前血栓评分≥4分和PCI前主动脉内气囊反搏(intra-aortic balloon pump,IABP)使用是无复流的独立预测因素(P<0.05).无复流发生率随着独立预测因素增加而显著增高(P<0.01).结论 STEMI患者急诊药物支架置入后无复流预测模型由6个因素组成:年龄> 65岁、再灌注时间>6h、侧支血流≤1级、APG> 13.0 mmol/L、PCI前血栓评分≥4分和PCI前IABP使用.
更多Objective To assess independent no-reflow predictors in patients with STEMI after primary drug-eluted stenting.Method A prospective study was carried out in 1413 patients with STEMI treated with primary drug-eluted stenting within 12 hours after onset of AMI from January 2007 through March 2010.The patients were divided into the no-reflow group and the normal reflow group.Univariate and multivariate logistic regression were applied to identification of no-reflow predictors.Results The no-reflow was found in 297(21.0%)of 1413 patients.Univariate and multivariate logistic regression identified that age >65 years,long time from onset to reperfusion >6 hours,admission plasma glucose(APG)> 13.0mmol/L,collateral circulation ≤ 1,pre-percutaneous coronary intervention(PCI)thrombus score ≥ 4,and intra-aortic balloon pump(IABP)used before PCI(P <0.05)were independent no-reflow predictors.The no-reflow rate significantly increased as the number of predictors increased(P < 0.01).Conclusions There are 6 factors associated with coronary no-reflow used for prediction in patients with STEMI after primary drug-eluted stenting.
More- 浏览:140
- 被引:23
- 下载:89
相似文献
- 中文期刊
- 外文期刊
- 学位论文
- 会议论文