急性下壁心肌梗死病人急诊PCI术中 出现无复流的相关危险因素探讨

目的探讨急性下壁心肌梗死病人直接经皮冠状动脉介入治疗（percutaneous coronary intervention，PCI）中无复流的发生情况及其危险因素。方法收集126例急性下壁心肌梗死行急诊PCI治疗病人的病历资料，采用logistic回归分析无复流发生的相关危险因素。结果126例急性下壁心肌梗死病人均成功进行急诊PCI治疗，其中有16例发生无复流，发生率12.70%。多因素logistic回归分析结果显示，急性下壁心肌梗死病人急诊PCI术中出现无复流的危险因素为糖尿病（OR=1.647，95%CI:1.242~1.845，P < 0.05）、发病至急诊PCI时间（OR=5.281，95%CI:2.782~10.018，P=0.002）、术前TIMI血流分级（≤1级）（OR=2.735，95%CI:1.040~3.062，P=0.020）和术前收缩压（OR=1.844，95%CI:1.153~3.638，P=0.015）。结论无复流在急性下壁心肌梗死病人急诊PCI术中具有较高的发生率，应对无复流发生的相关影响因素采取有效的预防措施，降低PCI术中出现无复流的风险。

Analysis of the related risk factor of no-reflow in patients with acute inferior myocardial infarction during PCI

ObjectiveTo investigate the risk factors of no-reflow in patients with acute inferior myocardial infarction during percutaneous coronary intervention(PCI).MethodsThe data of 126 acute inferior myocardial infarction patients treated with PCI were investigated, and the related risk factors of no-reflow were analyzed.ResultsOne hundred and twenty-six patients with acute inferior myocardial infarction were successfully treated with PCI, no-reflow in 16 cases were found, and the incidence rate of which was 12.70%.Logistic regression analysis showed that the diabetes(OR=1.047, 95%CI:1.019 to 1.233, P=0.036), reperfusion time(OR=5.281, 95%CI:2.782 to 10.018, P=0.002), TIMI flow grading before PCI(OR=1.735, 95%CI:1.040 to 3.062, P=0.020) and low systolic blood pressure before PCI(OR=1.844, 95%CI:1.153 to 3.638, P=0.015) were the risk factors of no-reflow.ConclusionsThe incidence of no-reflow in acute inferior myocardial infarction patients is high.The effectively preventive measures against the related risk factor of no-reflow should be implemented, which can reduce the no-reflow risk of PCI.