乜丽,赵汉军,颜红兵,刘臣,周鹏,盛兆雪,宋莉,谭明,刘可美,刘娟

• 1:中国医学科学院 北京协和医学院 国家心血管病中心 阜外心血管病医院冠心病中心心血管疾病国家重点实验室

摘要(Abstract)：

目的评价急性ST段抬高心肌梗死(STEMI)罪犯病变狭窄程度及其预测因素。方法连续回顾阜外心血管病医院2014年5月至2014年10月STEMI急诊经皮冠状动脉介入治疗(PCI)术中采用血栓抽吸患者的影像和临床资料。对血栓抽吸后影像进行冠状动脉造影定量分析,按罪犯病变直径狭窄程度分为非阻塞性病变组和阻塞性病变组,比较两组影像和临床资料特征,并分析非阻塞性病变的临床预测因素。结果共123例符合入选条件,其中非阻塞性病变48例(39.0%),阻塞性病变75例(61.0%)。非阻塞性病变组罪犯病变狭窄程度[(37.7±8.5)%比(65.2±10.1)%,P=0.000]、靶病变长度[(24.3±12.3)mm比(29.2±13.8)mm,P=0.048]以及支架置入率[33例(68.8%)比69例(92.0%),P=0.001]均小于阻塞性病变组,而最小管腔直径大于阻塞性病变组[(1.90±0.44)mm比(1.11±0.37)mm,P=0.000]。非阻塞性病变组既往PCI史比例高于阻塞性病变组[13例(27.1%)比5例(6.7%),P=0.002]。只有既往PCI史是罪犯病变为非阻塞性狭窄的预测因素(OR 4.881,95%CI 1.553~15.339,P=0.007),而性别、年龄、体质量指数、高血压、糖尿病、高脂血症以及无血管病史等与非阻塞性狭窄预测不具有相关性(均P>0.05)。结论大约40%的STEMI是由非阻塞性冠状动脉病变所致,既往PCI史是罪犯病变为非阻塞性狭窄的预测因素。

关键词(KeyWords)： 心肌梗死;血栓抽吸;非阻塞性冠状动脉狭窄;预测因素

Abstract:

Keywords:

基金项目(Foundation): 中央级公益性科研院所基本科研业务费专项资金/院所青年科学基金(2012-F25);; 北京市卫生科技成果与适宜技术推广项目(TG-2014-10)

作者(Author): 乜丽,赵汉军,颜红兵,刘臣,周鹏,盛兆雪,宋莉,谭明,刘可美,刘娟

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