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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

20卷

期数:

2014年03期

页码:

201-203

栏目:

临床医学

出版日期:

2014-05-20

文章信息/Info

Title:

Related factors of spontaneous reperfusion of infarction related artery in patients with acute ST-segment elevation myocardial infarction

文章编号:

1006-8147(2014)03-0201-03

作者:

劳 咪; 李广平; 张 跃; 李虹敏

（天津医科大学第二医院心脏科，天津 300211）

Author(s):

LAO Mi;  LI Guang-ping;  ZHAND Yue;  LI Hong-min

（Department of Cardiology, The Second Hospital, Tianjin Medical University, Tianjin 300211, China）

关键词:

心肌梗死; 梗死相关动脉; 自发再通; 梗死前心绞痛; 部分凝血活酶时间

Keywords:

 ; myocardial infarction;  infarction related artery;  spontaneous recanalization;  preinfarction angina;  partial throm boplastin time

分类号:

-

DOI:

-

文献标志码:

A

摘要:

 目的：观察急性ST段抬高型心肌梗死（STEMI）梗死相关动脉（IRA）自发再通（SR）患者的凝血功能指标，对其是否与SR相关进行分析。方法：连续入选STEMI且符合入选条件者共153例，根据急诊冠状动脉造影术中IRA血流分级，将其分为SR组51例，未自发再通（NSR）组102例。于患者入院时抽取静脉血，检测血小板功能参数、凝血常规、D-二聚体、肝肾功能等指标，分析两组患者的一般临床资料、检验指标、冠脉造影等资料特点。结果：两组在冠心病危险因素、肝肾功能、血小板功能参数、D-dimer等方面差异无统计学意义（P<0.05)。SR组梗死前心绞痛检出率显著高于NSR组(45.10% vs 26.47%，P<0.05)，部分凝血活酶时间(PTT)高于NSR组[（24.26 s±3.55 s） vs（22.93 s±3.49 s；P<0.05]。Pearson相关分析结果提示，梗死前心绞痛、PTT与IRA的SR有较强相关。结论: 梗死前心绞痛、PTT水平的延长可以作为冠脉自发再通的预测指标。

Abstract:

Objective: To observe the risk factors of spontaneous reperfusion(SR)in acute ST segment elevation myocardial infarction (STEMI) , and to discover its association with the SR. Methods: One hundred and fifty three patients with STEMI were enrolled in cohort and underwent emergent coronary angiography. The patients were divided into SR group (51 cases) and NSR group (102 cases) based on the TIMI grade. Venous blood was collected at admission for to detect platelet function parameters and blood coagulation routine, D-dimer, liver and kidney function. The clinical features, laboratory indexes and angiographic features of the patients were analyzed. Results: There was no significant difference(改为No significant differences were found) in risk factors such as coronary heart disease, liver and kidney function, platelet function parameters and D-dimer (all P>0.05) between the two groups. In SR group, percentage of preinfarction angina was significantly higher than that in NSR group (45.10% vs 26.47%，P<0.05); PTT levels were also significantly higher in SR group than in NSR group(24.26 s±3.55 s vs 22.93 s±3.49 s; P< 0.05). Strong correlation was found between PTT and SR based on pearson correlation analysis. Conclusion: Preinfarction angina and PTT can be used to predict SR of STEMI patients.

参考文献/References:

[1] Rentrop K P, Feit F, Blanke H, et al. Effects of intracoronary streptokinase and intracoronary nitroglycerin infusion on coronary angiographic patterns and mortality in patients with acute myocardial infarction[J]. N Engl J Med, 1984, 311(23): 1457
[2] 高润霖. 冠心病介入治疗的新进展, 解读我国更新的经皮冠状动脉介入治疗指南[J]. 中华心血管病杂志, 2009, 37(1): 2
[3] Gibson C M, Cannon C P, Murphy S A, et al. Relationship of the TIMI myocardial perfusion grades, flow grades, frame count, and percutaneous coronary intervention to long-term outcomes after thrombolytic administration in acute myocardial infarction[J]. Circulation, 2002, 105(16): 1909
[4] Yousef Z R, Redwood S R, Bucknall C A, et al. Late intervention after anterior myocardial infarction: effects on left ventricular size, function, quality of life, and exercise toleranceResults of the Open Artery Trial (TOAT Study)[J]. J Am Coll Cardiol, 2002, 40(5): 869
[5] Przyklenk K, Whittaker P. Brief Antecedent Ischemia Enhances Recombinant Tissue Plasminogen Activator–Induced Coronary Thrombolysis by Adenosine-Mediated Mechanism[J]. Circulation, 2000, 102(1): 88
[6] Rentrop K P. Thrombi in acute coronary syndromes: revisited and revised[J]. Circulation, 2000, 101(13): 1619
[7] Murry C E, Jennings R B, Reimer K A. Preconditioning with ischemia: a delay of lethal cell injury in ischemic myocardium[J]. Circulation, 1986, 74(5): 1124
[8] Kosuge M, Kimura K, Kojima S, et al. Effects of preinfarction angina pectoris on infarct size and in-hospital mortality after coronary intervention for acute myocardial infarction[J]. Am J Cardiol, 2003, 92(7): 840
[9] Przyklenk K, Whittaker P. Brief Antecedent Ischemia Enhances Recombinant Tissue Plasminogen Activator–Induced Coronary Thrombolysis by Adenosine-Mediated Mechanism[J]. Circulation, 2000, 102(1): 88
[10] 齐新, 刘丽芸, 李家增. 急性心肌梗死时凝血和纤溶系统的改变与溶栓治疗[J]. 天津医药, 2000, 28(4): 254
[11] Cemin R, Donazzan L, Lippi G, et al. Blood cells characteristics as determinants of acute myocardial infarction[J]. Clin Chem Lab Med, 2011, 49(7): 1231
[12] 廖荣宏, 刘作金, 李晓丽, 等. 血管内皮细胞损害与急性冠脉综合征患者凝血-纤溶状态改变的关系[J]. 第三军医大学学报, 2006, 28(12): 1311
[13] Huisse M G, Lanoy E, Tcheche D, et al. Prothrombotic markers and early spontaneous recanalization in ST-segment elevation myocardial infarction[J]. Thromb Haemost, 2007, 98(2): 420
[14] Skoric B, Milicic D, Lovric D, et al. Initial patency of the infarct-related artery in patients with acute ST elevation myocardial infarction is related to platelet response to aspirin[J]. Int J Cardiol, 2010, 140(3): 356
[15] Cagliyan C E, Yuregir O O, Balli M, et al. Plasminogen activator inhibitor-1 5G/5G genotype is associated with early spontaneous recanalization of the infarct-related artery in patients presenting with acute ST-elevation myocardial infarction[J]. Coron Artery Dis, 2013, 24(3): 196
[16] 徐云根, 何义, 徐丹蕾. 急诊室使用替罗非班对 IRA 再通和 TIMI 血流的影响[J]. 心脑血管病防治, 2012, 12(5): 368
[17] Huynh T, Theroux P, Snapinn S, et al. Effect of platelet glycoprotein IIb/IIIa receptor blockade with tirofiban on adverse cardiac events in women with unstable angina/non-ST–elevation myocardial infarction (PRISM-PLUS study)[J]. Am Heart J, 2003, 146(4): 668

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备注/Memo

备注/Memo:

作者简介 劳咪（1989-），女，硕士在读，研究方向：冠心病、心律失常基础及临床研究；通信作者：李广平，E-mail:tjcardiol@126.com。

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更新日期/Last Update: 2014-05-12