大样本冠状动脉慢血流的相关因素分析

目的 探讨冠状动脉慢血流(slow coronary flow，SCF)现象的相关因素。方法 回顾西京医院心内科2006年9月~2015年6月冠脉造影的患者85 668例，将冠脉血流仅为TIMI II级或以下的定义为SCF(SCF组，n=958)，选取同时期冠状动脉血流正常患者为对照组(n=507)，多因素分析采用Logistic回归分析。结果 SCF组男性比例、吸烟率、吸烟指数、白细胞计数、血红蛋白浓度、高密度脂蛋白胆固醇、血清载脂蛋白A1、血清载脂蛋白B、超敏C反应蛋白、胱抑素C均显著高于对照组，差异具有统计学意义（P<0.05或P<0.01）。多因素Logistic回归分析结果显示，性别（OR=15.119,95%CI 4.854-47.096,P<0.05）,年龄(OR=0.934,95%CI 0.879-0.974,P<0.05),心率(OR=1.045,95%CI 1.01-1.081，P<0.05),吸烟指数(OR=1.002,95%CI 1.0-1.003,P<0.01),血清载脂蛋白A1(OR=14.472,95%CI 5.446-38.455,P<0.05),为SCF的独立相关因素。结论 性别、年龄、心率，吸烟指数、血清载脂蛋白A1降低为本地区SCF的独立相关因素。

Analysis of risk factors for slow coronary flow in 958 patients

AIM To investigate the risk factors for slow coronary flow (SCF) phenomenon. METHODS We retrospectively analyzed 85,668 patients undergoing coronary angiography from September 2006 to June 2015. Patients with normal TIMI flow were selected as control. SCF was defined as TIMI flow 2. Logistic regression was used to analyze the risk factors of SCF. RESULTS Nine hundred and fifty-eight patients demonstrated SCF and the incidence of SCF was 1.1%. In patients with SCF, there were more smokers, lower heart rate and higher HDL, Apo-A1, Apo-B, cystatin C and C-reactive protein (CRP) serum concentration compared with those in patients with non-SCF (P<0.05, P<0.01). Using multivariate logistic regression analysis, we found that gender (OR=15.119, 95%CI 4.854-47.096, P<0.05), age (OR=0.934, 95% CI 0.879-0.974, P<0.05), smoking index (OR=1.002, 95%CI 1.0-1.003, P<0.01), heart rate (OR=1.045, 95%CI 1.01-1.081, P<0.05) and Apo-A1 (OR=14.472, 95%CI 5.446-38.455, P<0.05) were independent predictors of SCF. CONCLUSION Male, older age, smoking index, lower heart rate, reduced Apo-A1 and increased CRP are independent predictors of SCF.