[1]张铭炀,顾怡钰,王佐翔,等.急性前壁ST段抬高型心肌梗死患者急诊PCI后左室血栓形成的预测因素分析[J].医学信息,2023,36(01):80-85.[doi:10.3969/j.issn.1006-1959.2023.01.015]
　ZHANG Min-yang,GU Yi-yu,WANG Zu-xiang,et al.Analysis of Predictors of Left Ventricular Thrombosis After Emergency PCI in Patients with Acute Anterior ST-segment Elevation Myocardial Infarction[J].Journal of Medical Information,2023,36(01):80-85.[doi:10.3969/j.issn.1006-1959.2023.01.015]
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急性前壁ST段抬高型心肌梗死患者急诊PCI后左室血栓形成的预测因素分析()
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医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
36卷
期数:
2023年01期
页码:
80-85
栏目:
论著
出版日期:
2023-01-01

文章信息/Info

Title:
Analysis of Predictors of Left Ventricular Thrombosis After Emergency PCI in Patients with Acute Anterior ST-segment Elevation Myocardial Infarction
文章编号:
1006-1959（2023）01-0080-06
作者:
张铭炀; 顾怡钰; 王佐翔; 等
（苏州大学附属第一医院心血管内科，江苏 苏州 215000）
Author(s):
ZHANG Min-yang; GU Yi-yu; WANG Zu-xiang; et al.
(Department of Cardiovascular Medicine,the First Affiliated Hospital of Soochow University,Suzhou 215000,Jiangsu,China)
关键词:
急性前壁ST段抬高型心肌梗死; 左室血栓; 经皮冠脉介入术; 白蛋白
Keywords:
Acute anterior ST-segment elevation myocardial infarction; Left ventricular thrombosis; Percutaneous coronary intervention; Albumin
分类号:
R542.22
DOI:
10.3969/j.issn.1006-1959.2023.01.015
文献标志码:
A
摘要:
目的 探讨急性前壁ST段抬高型心肌梗死（STEMI）患者急诊经皮冠脉介入（pPCI）治疗后左室血栓（LVT）形成的危险因素，并构建其预测模型。方法 回顾性分析2014年1月-2020年12月因前壁STEMI就诊于苏州大学附属第一医院的患者565例，根据pPCI后是否合并LVT分为病例组51例和对照组514例。收集患者相关资料，应用多因素Logistic回归分析前壁STEMI患者pPCI后合并LVT的危险因素，运用R软件构建预测患者合并LVT的列线图模型，并进行内部验证。结果 单因素回归分析显示，年龄、肌酐、白蛋白（ALB）、左房内径、左室收缩末期内径内径、左室舒张末期内径、左室射血分数（LVEF）、总缺血时间（TIT）、pPCI后TIMI血流≤Ⅱ级与前壁STEMI患者pPCI后并发LVT相关（P＜0.05）；多因素回归分析显示，TIT＞7.4（OR=5.166，95%CI：2.463~10.835），LVEF＜39%（OR=2.361，95%CI：1.116~4.995），pPCI术后TIMI血流≤Ⅱ级（OR=3.141，95%CI：1.304~7.563）和ALB＜38（OR=2.182，95%CI：1.064~4.477）是前壁STEMI患者pPCI后并发LVT的独立危险因素（P＜0.05）；基于上述因素构建的Nomogram模型预测LVT形成的AUC为0.829（95%CI：0.767~0.891）。结论 TIT＞7.4，LVEF＜0.39，术后TIMI血流≤Ⅱ级和ALB＜38是前壁STEMI患者pPCI后并发LVT的独立危险因素，且本研究构建的列线图模型具有良好的预测价值。
Abstract:
Objective To investigate the risk factors of left ventricular thrombosis（LVT） after primary percutaneous coronary intervention（pPCI） in patients with acute anterior ST-segment elevation myocardial infarction（STEMI）and its prediction model.Methods A total of 565 patients with anterior STEMI who were admitted to the First Affiliated Hospital of Soochow University from January 2014 to December 2020 were retrospectively analyzed. According to whether LVT was combined after pPCI, they were divided into case group (51 cases) and control group (514 cases). Relevant data of patients were collected. Multivariate logistic regression was used to analyze the risk factors of LVT after pPCI in patients with anterior STEMI. R software was used to construct a nomogram model for predicting LVT in patients, and internal verification was performed.Results Univariate regression analysis showed that age, creatinine, albumin (ALB), left atrial diameter, left ventricular end-systolic diameter, left ventricular end-diastolic diameter, left ventricular ejection fraction (LVEF), total ischemic time (TIT), TIMI blood flow≤Ⅱ after pPCI were associated with LVT after pPCI in patients with anterior STEMI (P<0.05). Multivariate regression analysis showed that TIT>7.4 (OR=5.166,95%CI:2.463-10.835), LVEF<39% (OR=2.361,95%CI:1.116-4.995), TIMI blood flow≤Ⅱ after pPCI (OR=3.141,95%CI:1.304-7.563) and ALB<38 (OR=2.182,95%CI:1.064-4.477) were independent risk factors for LVT after pPCI in patients with anterior STEMI (P<0.05). The AUC of the Nomogram model based on the above factors was 0.829 (95%CI:0.767-0.891).Conclusion TIT>7.4, LVEF<0.39, postoperative TIMI blood flow≤Ⅱ and ALB<38 are independent risk factors for LVT after pPCI in patients with anterior STEMI, and the nomogram model constructed in this study has good predictive value.

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更新日期/Last Update: 1900-01-01