急性心肌梗死病人经皮冠状动脉介入术后支架内血栓形成的危险因素分析
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摘要
目的探讨急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)后支架内血栓形成的危险因素。方法研究对象为本院为2015年1月至2017年5月收治的急诊直接进行PCI的AMI死患者180例。术后随访1年,按照冠脉造影结果,将180例患者分为A组(支架内血栓形成,n=10)、B组(未出现支架内血栓形成,n=170)。对比两组患者临床资料,分析影响支架内血栓形成的危险因素。结果两组年龄、性别、高血压史、糖尿病史、血脂异常史、支架数量对比,结果无统计学意义(P> 0. 05);但A组左室心舒张末期直径大于B组,左心室收缩末期直径大于B组,支架直径小于B组,支架长度大于B组、左室射血分数<50%所占比高于B组,罪犯血管位于前降支率高于B组,首发临床诊断心肌梗死所占比高于B组,结果均有统计学意义(P <0. 05);实施多因素Logistic回归分析,影响A组支架内血栓形成的因素包括支架长度、支架直径、左室射血分数<50%所占比、首要诊断心肌梗死。结论支架长度、支架直径、左室射血分数<50%所占比、首要诊断心肌梗死等是影响AMI患者PCI术后支架内血栓形成的危险因素。
Objective To discuss the risk factors for the formation of thrombosis in patients with acute myocardial infarction( AMI) after percutaneous coronary intervention( PCI). Methods From January 2015 to may 2017,the 180 selected subjects were patients with AMI who were treated with PCI in our hospital. The patient and the family were informed of the agreement. All patients were treated with PCI According to the results of coronary angiography,180 patients were divided into group A( stent thrombosis,n = 10) and group B( not present stent thrombosis,n = 170). The clinical data of the two groups and the risk factors for the formation of thrombosis were analyzed. Results The results were not statistically significant in the age,gender,history of hypertension,history of diabetes,history of dyslipidemia,number of stents( P > 0. 05); but left ventricular end diastolic diameters were greater in group A than that in group B,left ventricular end systolic diameters were greater in group A than that in group B,stent diameters were greater in group A than that in group B,the length of the stents were larger in group A than that in group B,the left ventricular ejection fraction < 50% ratio was higher in group A than that in group B,the culprit artery located in the anterior descending artery was higher in group A than that in group B,the first clinical diagnosis of myocardial infarction was higher in group A than that in group B and all results were statistically significant( P < 0. 05). The multi factor Logistic regression analysis showed that the influence factors of stent thrombosis in the A group were the length of the stents,the diameter of the stents,left ventricular ejection fraction < 50% proportion,the primary diagnosis of myocardial infarction. Conclusion The length of the stents,the diameter of the stents,left ventricular ejection fraction < 50% ratio,and the primary diagnosis of myocardial infarction are the risk factors of stent thrombosis in patients with AMI after PCI.
Objective To discuss the risk factors for the formation of thrombosis in patients with acute myocardial infarction( AMI) after percutaneous coronary intervention( PCI). Methods From January 2015 to may 2017,the 180 selected subjects were patients with AMI who were treated with PCI in our hospital. The patient and the family were informed of the agreement. All patients were treated with PCI According to the results of coronary angiography,180 patients were divided into group A( stent thrombosis,n = 10) and group B( not present stent thrombosis,n = 170). The clinical data of the two groups and the risk factors for the formation of thrombosis were analyzed. Results The results were not statistically significant in the age,gender,history of hypertension,history of diabetes,history of dyslipidemia,number of stents( P > 0. 05); but left ventricular end diastolic diameters were greater in group A than that in group B,left ventricular end systolic diameters were greater in group A than that in group B,stent diameters were greater in group A than that in group B,the length of the stents were larger in group A than that in group B,the left ventricular ejection fraction < 50% ratio was higher in group A than that in group B,the culprit artery located in the anterior descending artery was higher in group A than that in group B,the first clinical diagnosis of myocardial infarction was higher in group A than that in group B and all results were statistically significant( P < 0. 05). The multi factor Logistic regression analysis showed that the influence factors of stent thrombosis in the A group were the length of the stents,the diameter of the stents,left ventricular ejection fraction < 50% proportion,the primary diagnosis of myocardial infarction. Conclusion The length of the stents,the diameter of the stents,left ventricular ejection fraction < 50% ratio,and the primary diagnosis of myocardial infarction are the risk factors of stent thrombosis in patients with AMI after PCI.
引文
[1]张燕,任艺虹,周超飞,等.经皮冠状动脉介入治疗术后急性、亚急性支架内血栓形成的危险因素分析[J].中国循环杂志,2013,28(1):17-20.
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[4]郑晓霞,梁燕琼,董华富,等.通心络胶囊联合替罗非班对PCI术后急性心肌梗死患者支架内血栓形成和炎症因子的影响[J].现代中西医结合杂志,2016,25(10):1054-1057.
[5]杜发旺.冠状动脉支架内血栓形成患者的危险因素及预后[J].介入放射学杂志,2016,25(2):160-163.
[6]邓红胜,张灿,陈炎,等.不同阶段冠状动脉支架内血栓形成的临床表现、治疗和预后[J].血栓与止血学,2013,19(5):202-204.
[7]CAIRONG L I,SHI J,JIN H,et al.Risk factors of stent thrombosis after percutaneous coronary intervention in acute myocardial infarction[J].Shanghai Medical Journal,2013,32(11):E49-E51.
[8]沈剑耀,王黎,张俐琴,等.急性心肌梗死PCI术后亚急性支架内血栓形成抢救成功1
[9]THANI K B,AL-MOOSA F,MURAD E,et al.Stent Thrombosis after Rescue Percutaneous Coronary Intervention in Acute ST-Segment Elevation Myocardial Infarction[J].Open Cardiovascular Medicine Journal,2015,9(1):127-132.
[10]DANGAS G D,SCHOOS M M,STEG P G,et al.Early Stent Thrombosis and Mortality After Primary Percutaneous Coronary Intervention in ST-Segment-Elevation Myocardial Infarction:A Patient-Level Analysis of 2 Randomized Trials[J].Circulation Cardiovascular Interventions,2016,9(5):e003272.
[2]班丽素,陈郁,张文玲,等.嗜酸性粒细胞计数与冠心病危险因素相关分析[J].标记免疫分析与临床,2015,22(7):608-610.
[3]曹建红,于萍,顾宇英,等.6例PCI术后支架内血栓形成患者的原因分析及防治[J].中国心血管病研究,2013,11(7):504-507.
[4]郑晓霞,梁燕琼,董华富,等.通心络胶囊联合替罗非班对PCI术后急性心肌梗死患者支架内血栓形成和炎症因子的影响[J].现代中西医结合杂志,2016,25(10):1054-1057.
[5]杜发旺.冠状动脉支架内血栓形成患者的危险因素及预后[J].介入放射学杂志,2016,25(2):160-163.
[6]邓红胜,张灿,陈炎,等.不同阶段冠状动脉支架内血栓形成的临床表现、治疗和预后[J].血栓与止血学,2013,19(5):202-204.
[7]CAIRONG L I,SHI J,JIN H,et al.Risk factors of stent thrombosis after percutaneous coronary intervention in acute myocardial infarction[J].Shanghai Medical Journal,2013,32(11):E49-E51.
[8]沈剑耀,王黎,张俐琴,等.急性心肌梗死PCI术后亚急性支架内血栓形成抢救成功1
[9]THANI K B,AL-MOOSA F,MURAD E,et al.Stent Thrombosis after Rescue Percutaneous Coronary Intervention in Acute ST-Segment Elevation Myocardial Infarction[J].Open Cardiovascular Medicine Journal,2015,9(1):127-132.
[10]DANGAS G D,SCHOOS M M,STEG P G,et al.Early Stent Thrombosis and Mortality After Primary Percutaneous Coronary Intervention in ST-Segment-Elevation Myocardial Infarction:A Patient-Level Analysis of 2 Randomized Trials[J].Circulation Cardiovascular Interventions,2016,9(5):e003272.
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