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	超重/肥胖对急性ST段抬高心肌梗死急诊经皮冠状动脉介入治疗心肌灌注的影响
	曾勇 ; 逯春鹏 ; 张抒扬 ; 沈珠军 ; 黄超联 ; 商丽华 ; 方全 ; ZENG Yong ; LU Chunpeng ; ZHANG Shuyang
	2010-06-09 ; 2010-06-09
关键词	超重 心肌梗死 冠状血管造影术 心电描记术 预后 Overweight Myocardial infarction Coronary angiography Electrocardiography Prognosis R542.22 R589.2
其他题名	Influence of overweight or obesity on reperfusion effects following primary angioplasty in patients with acute myocardial infarction
中文摘要	目的采用心电图ST段回落指数(ST-segment elevation resolution,STR)和冠状动脉造影心肌呈色分级(myocardial blush grade,MBG)评价超重/肥胖对急性心肌梗死(AMI)直接经皮冠状动脉介入治疗(PCI)后心肌灌注以及患者预后的影响。方法120例AMI并行急诊PCI治疗的超重/肥胖和体重正常患者,分析心电图ST段回落指数和MBG,并进行临床随诊。结果超重组、肥胖组和体重正常组PCI术后TIMI血流3级的患者比较差异无统计学意义。但超重组、肥胖组心肌微循环灌注不良多于体重正常组(MBG0/1级三组分别为44.6%、64.3%和30.6%,MBG2/3级三组分别为55.4%、35.7%和69.4%,P=0.027),超重组、肥胖组ST段回落不全也多于体重正常组(STR<50%三组分别为39.3%、57.1%和22.2%,STR≥50%三组分别为60.7%、42.9%和77.8%,P=0.017)。但超重组、肥胖组和体重正常组患者联合终点事件的发生率在随访期间差异无统计学意义(三组分别为16.1%、17.8%和16.7%,P=0.978)。COX比例风险回归分析显示体重对患者的预后无明显的预测价值[RR2.46(95%可信区间0.64~6.57),P=0.128]。结论在成功接受急诊介入治疗后,超重或肥胖患者更容易出现心肌微循环的障碍,但随诊期间患者的联合终点事件发生率差异并无明显统计学意义。; Objective To investigate the influence of overweight, obesity on myocardial perfusion following primary percutaneous coronary intervention (PCI) utilizing myocardial blush grade (MBG) and ST-segment elevation resolution (STR). Methods One hundren and twenty AMI patients with and without overweight/obesity after successful reperfusion therapy were analyzed by measuring MBG and STR. Results There were no differences between those with or without overweight/obesity with regards to achievement of post-procedural TIMI grade 3 flow (>95%). Patients with overweight/obesity were more likely to have absent myocardial perfusion (MBG 0/1 grade 44.6%、64.3% and 30.6%,MBG 2/3 grade 55.4%、35.7% and 69.4% respectively, P=0.027), and absence of STR (STR<50% 39.3%、57.1% and 22.2%,STR≥50% 60.7%、42.9% and 77.8% respectively,P=0.017) compared with patients with normal body mass. There was no difference in MACE among the three groups (16.1%、17.8% and 16.7% respectively, P=0.978). In univariate Cox regression analysis, overweight and obesity were not associated with clinical prognosis (RR=2.46, 95% CI 0.64～6.57, P=0.128).Conclusion Despite similar high rates of TIMI-3 flow after primary PCI in patients with or without overweight/obesity, patients with overweight/obesity are more likely to have abnormal myocardial reperfusion menifestated by both incomplete STR and reduced MBG. There is no difference in MACE between patients with and without overweight/obesity.
语种	中文 ; 中文
内容类型	期刊论文
源URL	[http://hdl.handle.net/123456789/58772]
专题	清华大学
推荐引用方式 GB/T 7714	曾勇,逯春鹏,张抒扬,等. 超重/肥胖对急性ST段抬高心肌梗死急诊经皮冠状动脉介入治疗心肌灌注的影响[J],2010, 2010.
APA	曾勇.,逯春鹏.,张抒扬.,沈珠军.,黄超联.,...&ZHANG Shuyang.(2010).超重/肥胖对急性ST段抬高心肌梗死急诊经皮冠状动脉介入治疗心肌灌注的影响..
MLA	曾勇,et al."超重/肥胖对急性ST段抬高心肌梗死急诊经皮冠状动脉介入治疗心肌灌注的影响".(2010).

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