本文關(guān)鍵詞： 心肌梗死 雌激素類 無復(fù)流　出處：《中國循環(huán)雜志》2017年06期 　論文類型：期刊論文

【摘要】：目的:探討絕經(jīng)后內(nèi)源性雌激素水平與急性ST段抬高型心肌梗死(STEMI)患者心肌再灌注后無復(fù)流的關(guān)系。方法:共納入絕經(jīng)后女性STEMI行急診經(jīng)皮冠狀動(dòng)脈介入治療(PCI)的患者100例,根據(jù)心肌再灌注后有無復(fù)流發(fā)生分為復(fù)流組77例和無復(fù)流組23例。心肌無復(fù)流定義為心肌再灌注后心肌梗死溶栓治療臨床試驗(yàn)(TIMI)血流≤2級(jí)或TIMI血流3級(jí)且心肌呈色分級(jí)(MBG)≤2級(jí)。所有患者均術(shù)前抽血檢測(cè)內(nèi)源性性激素水平。Logistic回歸分析內(nèi)源性性激素水平與心肌再灌注后無復(fù)流之間的關(guān)系。結(jié)果 :與復(fù)流組相比,無復(fù)流組雌酮、雌二醇和高敏C-反應(yīng)蛋白(hs-CRP)水平明顯升高(P0.05),而性激素結(jié)合球蛋白(SHBG)水平則降低(P0.05)。單因素分析結(jié)果提示病灶長度、血栓負(fù)荷評(píng)分≥4分、雌酮、雌二醇和hs-CRP水平與心肌再灌注后無復(fù)流發(fā)生呈正相關(guān)(P0.05)。進(jìn)一步的多因素Logistic回歸分析表明血栓負(fù)荷評(píng)分≥4分(OR=4.994,95%CI:1.987~10.518,P=0.035)和雌二醇水平(OR=4.091,95%CI:1.105~8.582,P=0.046)是心肌再灌注后無復(fù)流發(fā)生的獨(dú)立危險(xiǎn)因素。結(jié)論 :在絕經(jīng)后女性STEMI患者中,高水平內(nèi)源性雌二醇和心肌再灌注后無復(fù)流的發(fā)生呈正相關(guān),提示內(nèi)源性雌二醇可能是心肌再灌注后無復(fù)流發(fā)生的獨(dú)立危險(xiǎn)因素。
[Abstract]:Objective: to investigate the relationship between endogenous estrogen level after menopause and no reflow after myocardial reperfusion in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: a total of 100 postmenopausal women with STEMI underwent emergency percutaneous coronary intervention (PCI). According to the occurrence of reflow after myocardial reperfusion, there were 77 cases in reflow group and 23 cases in non-reflow group. Myocardial non-reflow was defined as myocardial infarction thrombolytic therapy after myocardial reperfusion. All patients were examined before operation for endogenous sex hormone level. Logistic regression analysis showed the relationship between endogenous sex hormone level and no reflow after myocardial reperfusion. Results: compared with reflow group, all patients had no reflow. In no reflow group, the levels of estradiol, estradiol and Gao Min C-reactive protein hs-CRP increased significantly, while the level of sex hormone binding globulin (SHBG) decreased P0.050.The results of univariate analysis showed that the lesion length, thrombus load score 鈮，

本文編號(hào)：1509028