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目的 通过冠状动脉造影影像特征发现急性ST段抬高型心肌梗死患者罪犯病变分支闭塞的预测因素.方法 连续入选2014年1月至2015年12月阜外医院诊断急性ST段抬高型心肌梗死且行直接经皮冠状动脉介入治疗的患者共1223例,根据冠状动脉造影筛选出罪犯病变为分叉病变的患者共256例,收集患者的人口学资料、合并疾病及冠状动脉造影影像特征资料.结果 256例患者中,33例发生分支闭塞,223例未发生分支闭塞,多因素分析显示分支开口狭窄程度重(比值比为1.06, 95%CI 1.03~1.09,P<0.001)和分支开口血栓(比值比为5.43,95%CI 1.23~23.93,P=0.025)是预测分支闭塞的独立危险因素.结论 急性ST段抬高型心肌梗死患者罪犯病变分支闭塞与分支开口狭窄程度重和分支开口血栓有关.“,”Objective To explore the predictive factors of side branch occlusion in patients with ST-segment elevation myocardial infarction by coronary angiography. Methods A total of 1223 patients with acute ST segment elevation myocardial infarction undergoing primary percutaneous coronary intervention were consecutively enrolled in Fuwai hospital from January 2014 to December 2015. According to the coronary angiography there were 256 patients with bifurcation in the culprit lesions. Demographic data, past medical history and coronary angiography characteristics were collected in all patients. Results Among the 256 patients, there were 33 patients with branch occlusion and 223 patients without branch occlusion. Multivariate analysis demonstrated that severe stenosis of side branch ostium odds ratio 1.06, 95% confi dence interval 1.03-1.09,P < 0.001) and thrombus in side branch ostium (odds ratio 5.43, 95% confidence interval 1.23-23.93, P=0.025) were independent risk factors for predicting branch occlusion. Conclusions Side branch occlusion in culprit lesions of patients with ST-segment elevation myocardial infarction is related to the severity of branch ostium stenosis and thrombosis in branch ostium.