急性心肌梗死患者急诊介入治疗术后慢血流影响因素分析

目的：探讨急性心肌梗死（AMI）患者急诊介入治疗术（PCI）后慢血流发生的影响因素.方法：回顾性分析我院2010年1月至2011年6月于我院诊断为AMI并行急诊PCI治疗的488例患者的临床及冠脉介入治疗影像资料,其中慢血流组（TIMI≤2级）51例,正常血流组（TIMI3级）437例;分析两组临床特点的差别.结果：与正常血流组比较,慢血流组术中血栓抽吸（75.3％比60.8％）、血小板糖蛋白Ⅱb/Ⅲa受体拮抗剂应用（81.7％比68.6％）比例显著减小,植入支架总长度显著增加[（31.8±12.2） mm比（35.7±12.0） mm],P均＜0.05.多因素Logistic回归分析表明,术中血栓抽吸和总支架长度是慢血流发生的独立影响因素（P均＜0.05）.结论：PCI术中血栓抽吸和总支架长度是慢血流发生的独立影响因素.

Analysis of influencing factors for slow blood flow phenomenon after emergency percutaneous coronary intervention in patients with acute myocardial infarction

Objective： To explore the influencing factors of slow blood flow phenomenon after emergency percutanecoronary intervention （PCI） in patients with acute myocardial infarction （AMI）. Methods： Clinical and PCI angiographic data of 488 patients, who were diagnosed as AMI and received primary PCI in our hospital from Jan 2010 to Jun 2011, were retrospectively analyzed. Patients were divided into slow blood flow group （n= 51, TIMI flow grade 2） and normal flow group （n= 437, TIMI flow= grade 3）. Their clinical characteristics between two groups were compared. Results： Compared with normal flow group, there were significant reductions in percentages of thrombus aspiration （75.3% vs. 60.8%） and application of platelet glycoprotein IIb/Illa receptor antagonist （81.7% vs. 68.6%） during PCI, and significant rise in total length of implanted stents [ （31.8±12.2） mm vs. （35.7±12.0） mm2 in slow blood flow group, P〈0.05 all. Multi-factor Logistic regression analysis indicated that percentages of thrombus aspiration during PCI and total length of stents were independent influencing factors for slow blood flow （P〈0.05 both）. Conclusion： Percentages of thrombus aspiration and total length of stents during PCI are independent influencing factors for slow blood flow.