ST 段抬高型心肌梗死患者梗死相关动脉自发再通的相关因素

目的：观察急性ST段抬高型心肌梗死（STEMI）梗死相关动脉（IRA）自发再通（SR）患者的凝血功能指标，对其是否与SR相关进行分析。方法：连续入选STEMI且符合入选条件者共153例，根据急诊冠状动脉造影术中IRA血流分级，将其分为SR组51例，未自发再通（NSR）组102例。于患者入院时抽取静脉血，检测血小板功能参数、凝血常规、D-二聚体、肝肾功能等指标，分析两组患者的一般临床资料、检验指标、冠脉造影等资料特点。结果：两组在冠心病危险因素、肝肾功能、血小板功能参数、D-二聚体等方面差异无统计学意义（P〈0．05）。SR组梗死前心绞痛检出率显著高于NSR组（45．10％ vs 526．47％，P〈0．05），部分凝血活酶时间（P1阿）高于NSR组（24．26±3．55）s vs（22．93±3．49）s；P〈0．051。Pearson相关分析结果提示，梗死前心绞痛、PTT与IRA的SR有较强相关。结论：梗死前心绞痛、PTT水平的延长可以作为冠脉自发再通的预测指标。

Related factors of spontaneous reperfusion of infarction related artery in patients with acute ST-segment elevation myocardial infarction

Objective： To observe the risk factors of spontaneous reperfusion （SR） in acute ST segment elevation myocardial infarction （STEMI）, and to discover its association with the SR. Methods： One hundred and fifty three patients with STEMI were enrolled in cohort and underwent emergent coronary angiography. The patients were divided into SR group （51 cases） and NSR group （102 cases） based on the TIMI grade. Venous blood was collected at admission for to detect platelet function parameters and blood coagulation routine, D-dimer, liver and kidney function. The clinical features, laboratory indexes and angiographie features of the patients were analyzed. Results： No significant differences were found in risk factors such as coronary heart disease, liver and kidney function, platelet function parameters and D-dimer （all P〉0.05） between the two groups. In SR group, percentage of preinfarction angina was significantly higher than that in NSR group （45.10% vs 26.47%,P〈0.05）; PTT levels were also significantly higher in SR group than in NSR group（24.26 s±3.55 s vs 22.93 s±3.49 s; P〈 0.05）. Strong correlation was found between PTT and SR based on pearson correlation analysis. Conclusion： Preinfaretion angina and PTT can be used to predict SR of STEMI patients.