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目的探讨老年急性ST段抬高心肌梗死(ST-segment elevation acute myocardial infarction,STEAMI)患者行急诊经皮冠状动脉介入治疗(PCI)术中发生无复流的临床因素。方法因STEAMI行急诊PCI治疗老年患者68例,分为正常复流组(54例)和无复流组(14例),通过比较2组患者的临床资料来阐明老年STEAMI患者无复流发生的相关影响因素。结果行急诊PCI后无复流发生率为20.6%(14/68),无复流组与正常复流组相比,2组之间入院收缩压(SBP)、2型糖尿病患病数、发病-再灌注时间、球囊扩张次数和靶血管植入支架数量差异均有统计学意义(P<0.05);经多因素Logistic回归分析显示入院SBP<100 mmHg、合并糖尿病、球囊扩张次数和发病-再灌注时间是老年患者急诊PCI术后无复流发生的危险因素。结论老年STEAMI患者行急诊PCI后无复流发生与入院SBP<100 mmHg、合并糖尿病、球囊扩张次数及发病-再灌注时间等临床因素具有相关性。
Objective To investigate the clinical factors of no-reflow during emergency percutaneous coronary intervention (PCI) in elderly patients with ST-segment elevation acute myocardial infarction (STEAMI). Methods Sixty-eight elderly patients with STEAMI undergoing emergency PCI were divided into two groups according to the clinical data of two groups: 54 cases of normal recurrence group and 14 cases of no-reflow group. Related factors. Results The rate of no-reflow after PCI was 20.6% (14/68). There was no significant difference in the incidence of SBP, type 2 diabetes mellitus between the two groups --Reperfusion time, the number of balloon dilatation and the number of target vessel implantation stents were statistically significant (P <0.05) .Multivariate Logistic regression analysis showed that admission SBP <100 mmHg, combined with diabetes, the number and duration of balloon dilatation Reperfusion time is a risk factor of no-reflow in elderly patients after emergency PCI. Conclusions The incidence of no-reflow after PCI in elderly patients with STEAMI is correlated with clinical factors such as admission SBP <100 mmHg, diabetes mellitus, number of balloon dilatation and incidence-reperfusion time.