微创医学

目的探讨ST段抬高型心肌梗死（STEMI）患者经皮冠状动脉介入术(PCI) 术后1年内发生支架内血栓的危险因素。方法回顾性分析行PCI治疗的200例STEMI患者的临床资料，根据PCI术后1年内是否出现支架内血栓将患者分为血栓组（n=17）和无血栓组（n=183）。通过医院信息系统收集患者的一般资料、实验室检查指标、术前冠状动脉造影及介入治疗情况等资料。采用多因素Logistic回归分析STEMI患者PCI术后1年内支架内血栓形成的危险因素。结果多因素Logistic回归分析结果显示，血清脂蛋白（a）水平≥300 mg/L、左室射血分数（LVEF）低、支架贴壁不良、支架直径过小是STEMI患者PCI术后1年内支架内血栓形成的独立危险因素（均P＜0.05）。结论血清脂蛋白（a）水平过高、LVEF较低、支架贴壁不良、支架直径过小是STEMI患者PCI术后1年内支架内血栓发生的危险因素。临床可通过动态监测上述指标评估STEMI患者PCI术后1年内支架内血栓的发生风险。

ObjectiveTo investigate the risk factors of stent thrombosis in patients with ST-segment elevation myocardial infarction (STEMI) within 1 year after percutaneous coronary intervention (PCI). MethodsThe clinical data of 200 STEMI patients who underwent PCI were retrospectively analyzed, and patients were divided into thrombosis group (n=17) and non-thrombosis group (n=183) according to the presence or absence of stent thrombosis within 1-year after PCI. Information such as general data, laboratory examination indicators, preoperative coronary angiography data and interventional therapy was collected through the hospital information system. Multivariate logistic regression was used to analyze the risk factors of stent thrombosis in STEMI patients within 1 year after PCI. ResultsThe result of multivariate logistic regression analysis showed that serum lipoprotein (a) level ≥300 mg/L, low left ventricular ejection fraction (LVEF), poor stent adhesion and excessively small stent diameter were independent risk factors for stent thrombosis in STEMI patients within 1 year after PCI (all P＜0.05). ConclusionThe high serum lipoprotein (a) level, low LVEF, poor stent adhesion and excessively small stent diameter are the risk factors for stent thrombosis in STEMI patients within 1 year after PCI. The risk of stent thrombosis in STEMI patients within 1 year after PCI can be assessed clinically by dynamic monitoring of the above indicators.