【摘要】 目的 探讨急性ST段抬高心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)后发生左心室血栓的影响因素。方法 选取2018年2月至2021年2月信阳市中心医院收治的810例急性STEMI患者为研究对象，均行PCI治疗。治疗后2周，采用经胸超声心动图检查患者左心室血栓发生情况；同时询问并记录患者PCI治疗前的基线资料、心功能[左心室舒张未期内径(LVEDD)、左心室射血射血分数(LVEF)]及其他实验室指标[纤维蛋白原(Fib)、平均血小板与淋巴细胞比值(PLR)、血小板体积(MPV)、中性粒细胞与淋巴细胞比值(NLR)]。分析STEMI患者PCI后发生左心室血栓的影响因素。结果 经评估，810例急性STEMI患者PCI后发生左心室血栓35例，占4.32%;发生组LVEDD大于未发生组，LVEF低于未发生组，Fib水平高于未发生组，差异有统计学意义(P<0.05);两组其他资料比较，差异无统计学意义(P>0.05);logistic回归分析结果显示，LVEDD较大、Fib水平较高是急性STEMI患者PCI后发生左心室血栓的影响因素(OR>1,P<0.05),LVEF较高是其保护因素(OR<1,P<0.05)。结论 急性STEMI患者PCI后发生左心室血栓与LVEDD较大、LVEF较低、Fib水平较高有关。更多还原

【Abstract】 Objective To investigate the influencing factors of left ventricular thrombosis after percutaneous coronary intervention(PCI) in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 810 patients with acute STEMI treated by PCI in Xinyang Central Hospital from February 2018 to February 2021 were selected as the study subjects, all received PCI treatment. Two weeks after treatment, the occurrence of left ventricular thrombosis of patients was examined by transthoracic echocardiography, and at the same time, the baseline data, cardiac function [left ventricular diastolic diameter(LVEDD), left ventricular ejection fraction(LVEF)] and other laboratory indexes [fibrinogen(Fib), mean platelet to lymphocyte ratio(PLR), platelet volume(MPV), neutrophil to lymphocyte ratio(NLR)] of patients before PCI were asked and recorded. The influencing factors of left ventricular thrombosis after PCI in STEMI patients were analyzed.Results After evaluation, 35 of 810 patients with acute STEMI developed left ventricular thrombosis after PCI, accounting for 4.32%. Compared with the non-occurrence group, LVEDD was higher, LVEF was lower and Fib level was higher in the occurrence group(P<0.05). There was no statistical difference in other data between the two groups(P>0.05). The results of logistic regression analysis showed that larger LVEDD and higher Fib level were the influencing factors of left ventricular thrombosis after PCI in patients with acute STEMI(OR>1, P<0.05), and higher LVEF was its protective factor(OR<1, P<0.05).Conclusion Left ventricular thrombosis after PCI in patients with acute STEMI is related to larger LVEDD, lower LVEF and higher Fib level.更多还原