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吴彩凤, 徐日新, 张强, 程铖, 谢勇, 刘晓东, 曹天庆, 梅宏斌. 微循环阻力指数评估急性前壁ST段抬高型心肌梗死患者急诊冠状动脉介入治疗预后的价值及相关影响因素[J]. 实用临床医药杂志, 2019, 23(16): 65-69, 75. DOI: 10.7619/jcmp.201916018
引用本文: 吴彩凤, 徐日新, 张强, 程铖, 谢勇, 刘晓东, 曹天庆, 梅宏斌. 微循环阻力指数评估急性前壁ST段抬高型心肌梗死患者急诊冠状动脉介入治疗预后的价值及相关影响因素[J]. 实用临床医药杂志, 2019, 23(16): 65-69, 75. DOI: 10.7619/jcmp.201916018
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WU Caifeng, XU Rixin, ZHANG Qiang, CHENG Cheng, XIE Yong, LIU Xiaodong, CAO Tianqing, MEI Hongbin. Value of microcirculation resistance index in evaluating prognosis of patients with acute anterior ST-segment elevation myocardial infarction after emergency percutaneous coronary intervention andrelated influencing factors[J]. Journal of Clinical Medicine in Practice, 2019, 23(16): 65-69, 75. DOI: 10.7619/jcmp.201916018
Citation: WU Caifeng, XU Rixin, ZHANG Qiang, CHENG Cheng, XIE Yong, LIU Xiaodong, CAO Tianqing, MEI Hongbin. Value of microcirculation resistance index in evaluating prognosis of patients with acute anterior ST-segment elevation myocardial infarction after emergency percutaneous coronary intervention andrelated influencing factors[J]. Journal of Clinical Medicine in Practice, 2019, 23(16): 65-69, 75. DOI: 10.7619/jcmp.201916018
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微循环阻力指数评估急性前壁ST段抬高型心肌梗死患者急诊冠状动脉介入治疗预后的价值及相关影响因素

Value of microcirculation resistance index in evaluating prognosis of patients with acute anterior ST-segment elevation myocardial infarction after emergency percutaneous coronary intervention andrelated influencing factors

    摘要
  • 摘要:
      目的  探讨微循环阻力指数(IMR)评估急性前壁ST段抬高型心肌梗死(STEMI)患者急诊冠状动脉介入治疗(PCI)预后的价值及影响因素。
      方法  选取行急诊PCI的急性前壁STEMI患者50例, 在PCI后立即测量IMR。以IMR=40 U为临界值，将IMR < 40 U定义为微循环正常组(A组)，将IMR≥40 U定义为微循环异常组(B组)。分析2组患者一般资料、实验室检查结果、术中相关情况，以及术后24 h、术后6个月、术后12个月的超声心动图结果及术后随访12个月的主要心脏不良事件(MACE)情况。
      结果  Logistic回归分析发现，症状发作至球囊扩张时间(STB)是影响急性前壁STEMI患者微循环障碍的独立危险因素。在PCI术后24 h、6个月、12个月时, 2组左室射血分数(LVEF)、左室舒张末容积内径(LVEDD)比较，差异有统计学意义(P < 0.05)。2组患者MACE情况比较，差异有统计学意义(P < 0.05)。
      结论  STB是急性前壁STEMI患者微循环障碍的独立危险因素, IMR对急性前壁STEMI患者PCI术后左心重构、左心功能恢复及主要心脏不良事件的发生可能有较好的早期预测价值。

     

    Abstract:
      Objective  To investigate the value of microcirculation resistance index (IMR) in evaluating prognosis of patients with acute anterior ST-segment elevation myocardial infarction (STEMI) after emergency percutaneous coronary intervention (PCI) and related influencing factors.
      Methods  Totally 50 patients with acute anterior STEMI by PCI were selected, and IMR was measured immediately after PCI. Taking IMR=40 U as the cutoff value, patients with IMR < 40 U was defined as normal microcirculation group (group A), and those with IMR≥40 U was defined as abnormal microcirculation group (group B). The general data, laboratory results, intraoperative information, and echocardiographic results at 24 hours, 6 months and 12 months after operation were analyzed. Major adverse cardiac events (MACE) at 12 months after operation were analyzed.
      Results  Logistic regression analysis showed that time from onset of symptoms to balloon dilation (STB) was an independent risk factor for microcirculation disorders in acute anterior STEMI patients. At 24 hours, 6 months and 12 months after PCI, there were significant differences in the left ventricular ejection fraction (LVEF) and left ventricular end-diastolic volume diameter (LVEDD) between the two groups (P < 0.05). There was a significant difference in MACE between the two groups (P < 0.05).
      Conclusion  STB is an independent risk factor for microcirculation disorders in acute anterior STEMI patients. IMR may have a good early predictive value for left ventricular remodeling, recovery of left cardiac function and incidence of MACE after PCI in acute anterior STEMI patients.

     

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