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接受经皮冠状动脉介入治疗的ST段抬高型心肌梗死患者无复流的危险因素:一项病例对照研究。

Risk Factors for No-Reflow in Patients with ST-Elevation Myocardial Infarction Who Underwent Percutaneous Coronary Intervention: A Case-Control Study.

作者信息

Yu Ying, Wu Yongquan, Wu Xianyi, Wang Jinwen, Wang Changhua

机构信息

Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.

Daytime Diagnosis and Treatment Department, The Fifth Medical Center of PLA General Hospital, Beijing, China.

出版信息

Cardiol Res Pract. 2022 Mar 10;2022:3482518. doi: 10.1155/2022/3482518. eCollection 2022.

Abstract

METHODS

This case-control study retrospectively reviewed the medical data of patients treated with primary percutaneous coronary intervention within 12 h after STEMI onset between January 2010 and January 2013 at the Department of Cardiology of the Beijing Anzhen Hospital.

RESULTS

A total of 902 patients were included in the analysis. The basic characteristics between the reflow and no-reflow groups were similar, except for time-to-hospital admission, heart rate, plasma glucose, high-sensitivity C-reactive protein (hsCRP)/prealbumin (PAB), neutrophil count, intraaortic balloon pump, and aspiration thrombectomy. The multivariable analysis showed that hsCRP/PAB (OR = 1.003, 95% CI: 1.000-1.006, =0.022), neutrophil count (OR = 1.085, 95% CI: 1.028-1.146, =0.003), plasma glucose levels (OR = 1.086, 95% CI: 1.036-1.138, =0.001), diabetes mellitus (OR = 0.596, 95% CI: 0.371-0.958, =0.033), Killip classification >1 (OR = 2.002, 95% CI: 1.273-3.148, =0.003), intraoperative intraaortic balloon pump (IABP) use (OR = 3.257, 95% CI: 1.954-5.428, =0.001), and aspiration thrombectomy (OR = 3.412, 95% CI: 2.259-5.152, =0.001) were independently associated with no-reflow.

CONCLUSION

hsCRP/PAB, neutrophil count, plasma glucose levels, diabetes mellitus, Killip classification, intraoperative IABP use, and aspiration thrombectomy were independent risk factors for no-reflow in patients with STEMI.

摘要

方法

本病例对照研究回顾性分析了2010年1月至2013年1月在北京安贞医院心内科接受ST段抬高型心肌梗死(STEMI)发病后12小时内首次经皮冠状动脉介入治疗患者的医疗数据。

结果

共902例患者纳入分析。除入院时间、心率、血糖、高敏C反应蛋白(hsCRP)/前白蛋白(PAB)、中性粒细胞计数、主动脉内球囊反搏及血栓抽吸术外,再灌注组与无再灌注组的基本特征相似。多变量分析显示,hsCRP/PAB(比值比[OR]=1.003,95%可信区间[CI]:1.000 - 1.006,P=0.022)、中性粒细胞计数(OR=1.085,95%CI:1.028 - 1.146,P=0.003)、血糖水平(OR=1.086,95%CI:1.036 - 1.138,P=0.001)、糖尿病(OR=0.596,95%CI:0.371 - 0.958,P=0.033)、Killip分级>1(OR=2.002,95%CI:1.273 - 3.148,P=0.003)、术中使用主动脉内球囊反搏(IABP)(OR=3.257,95%CI:1.954 - 5.428,P=0.001)及血栓抽吸术(OR=3.412,95%CI:2.259 - 5.152,P=0.001)与无再灌注独立相关。

结论

hsCRP/PAB、中性粒细胞计数、血糖水平、糖尿病、Killip分级术中IABP使用及血栓抽吸术是STEMI患者无再灌注的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7591/8930256/0d4bfc333caa/CRP2022-3482518.001.jpg

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