急诊经皮冠状动脉介入治疗冠状动脉造影无复流的相关因素Relative factors for angiographic no-reflow phenomenon after primary percutaneous coronary intervention with acute myocardial infarction
杨新春,郭军,王乐丰,程祖亨,葛永贵,王红石,邹阳春,佟子川,李惟铭,徐立
摘要(Abstract)：
目的 探讨急诊经皮冠状动脉介入治疗 (percutaneouscoronaryinterventions,PCI)冠状动脉(冠脉 )造影无复流现象的相关因素。方法 自 1999年 1月至 2 0 0 2年 10月 ,回顾性分析 4 97例急诊PCI病人的临床和冠脉造影资料 ,冠脉造影无复流病人 5 8例 ,由其余的 4 39例急诊PCI冠脉前向血流TIMI 3级的病人中随机抽取 6 0例 ,为正常血流组。运用Logistic回归分析无复流的相关因素。结果 无复流的发生率为 12 6 %。单因素分析表明 :糖尿病、症状开始到再灌注的时间、梗死前心绞痛、Kil lip心功能分级、Q波计数、室壁运动积分差异有显著性。而多因素Logistic回归分析表明 :症状开始到再灌注的时间、梗死前心绞痛、Killip心功能分级、Q波计数是无复流的相关因素。结论 大面积心肌坏死、严重的心肌损害、心功能不全和症状开始到再灌注的时间长 ,可能会促使无复流的形成 ;梗死前心绞痛可能减少无复流的发生。而冠心病的危险因素与无复流没有相关性。
关键词(KeyWords)： 急性心肌梗死;经皮冠状动脉介入治疗;无复流
基金项目(Foundation):
作者(Author): 杨新春,郭军,王乐丰,程祖亨,葛永贵,王红石,邹阳春,佟子川,李惟铭,徐立
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