本文選題：急性冠狀動(dòng)脈綜合征 + 同型半胱氨酸　； 參考：《中國全科醫(yī)學(xué)》2017年07期

【摘要】：背景冠狀動(dòng)脈慢復(fù)流(CSRF)/無復(fù)流(no-RF)是經(jīng)皮冠狀動(dòng)脈介入(PCI)治療的重要并發(fā)癥,而目前對其發(fā)病機(jī)制及臨床預(yù)后研究較少。目的觀察血漿同型半胱氨酸(Hcy)水平對PCI術(shù)中CSRF/no-RF現(xiàn)象、圍術(shù)期心肌梗死(PMI)及預(yù)后的影響。方法選取2013年1月—2015年5月在首都醫(yī)科大學(xué)附屬復(fù)興醫(yī)院心內(nèi)科及中國醫(yī)學(xué)科學(xué)院附屬阜外醫(yī)院冠心病中心擇期行PCI治療的非ST段抬高急性冠脈綜合征(NSTE-ACS)患者269例。根據(jù)血漿Hcy水平將所有患者分為Hcy正常組(15μmol/L,n=172)和Hcy升高組(≥15μmol/L,n=97)。比較兩組CSRF/no-RF、PMI發(fā)生率及PCI術(shù)后1年內(nèi)主要不良心血管事件(MACE)發(fā)生率、全因死亡率。結(jié)果兩組性別、年齡、吸煙率、高血壓發(fā)生率、糖尿病發(fā)生率和總膽固醇(TC)、三酰甘油(TG)、低密度脂蛋白膽固醇(LDL-C)、高密度脂蛋白膽固醇(HDL-C)水平及阿司匹林、氯吡格雷/替格瑞洛、β-受體阻滯劑、血管緊張素轉(zhuǎn)換酶抑制劑(ACEI)/血管緊張素受體拮抗劑(ARB)、他汀類藥物使用率間差異無統(tǒng)計(jì)學(xué)意義(P0.05),而冠狀動(dòng)脈病變情況間差異有統(tǒng)計(jì)學(xué)意義(P0.05)。Hcy升高組CSRF/no-RF、PMI發(fā)生率均高于Hcy正常組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組單支病變MACE發(fā)生率間差異無統(tǒng)計(jì)學(xué)意義(P0.05);而Hcy升高組雙支病變、多支病變及總體MACE發(fā)生率高于Hcy正常組,差異有統(tǒng)計(jì)學(xué)意義(P0.05);Hcy升高組總體全因死亡率高于Hcy正常組,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論高血漿Hcy水平對NSTE-ACS患者術(shù)中CSRF/no-RF、PMI和預(yù)后有較為重要的影響。
[Abstract]:Background CSRFR / no-RFR is an important complication of percutaneous coronary intervention (PCI) treatment, but there are few studies on its pathogenesis and clinical prognosis. Objective to investigate the effect of plasma homocysteine (HCH) on CSRF / no-RF (CSRF / no-RF), perioperative myocardial infarction (PMIs) and prognosis during PCI. Methods 269 patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACSS) were selected from January 2013 to May 2015 in Cardiology Department of Renaissance Hospital affiliated to Capital Medical University and Center of Coronary Heart Disease of Fuwei Hospital affiliated to Chinese Academy of Medical Sciences. According to plasma Hcy level, all patients were divided into two groups: normal Hcy group (15 渭 mol / L) and Hcy increased group (鈮，

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