發(fā)布時(shí)間：2019-04-15 20:16

【摘要】：目的:探討冠狀動(dòng)脈造影慢血流患者的影響因素。方法:回顧性分析2008-01至2010-09于濱州醫(yī)學(xué)院附屬醫(yī)院行冠狀動(dòng)脈造影檢查的1 530例患者中的冠狀動(dòng)脈造影結(jié)果,入選患者根據(jù)校正的心肌梗死溶栓治療臨床試驗(yàn)(TIMI)后血流計(jì)幀數(shù)篩選出冠狀動(dòng)脈無(wú)明顯狹窄但冠狀動(dòng)脈血流緩慢者139例為試驗(yàn)組,同期冠狀動(dòng)脈無(wú)明顯狹窄且血流正常的患者232例作為對(duì)照組。統(tǒng)計(jì)常規(guī)臨床實(shí)驗(yàn)室指標(biāo),比較兩組患者的一般情況、實(shí)驗(yàn)室檢查指標(biāo)的差異、危險(xiǎn)因素,并通過(guò)多因素Logistic回歸分析冠狀動(dòng)脈慢血流的臨床影響因素。結(jié)果:(1)兩組患者比較,年齡、性別、吸煙史、糖尿病病史、紅細(xì)胞、血紅蛋白、平均紅細(xì)胞血紅蛋白濃度、紅細(xì)胞壓積、中性粒細(xì)胞、單核細(xì)胞、嗜堿性粒細(xì)胞、淋巴細(xì)胞/單核細(xì)胞、中性粒細(xì)胞/單核細(xì)胞、平均紅細(xì)胞體積、紅細(xì)胞分布寬度SD、中性粒細(xì)胞/淋巴細(xì)胞、血小板/淋巴細(xì)胞、谷草轉(zhuǎn)氨酶、肌酸激酶及總膽汁酸差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)相關(guān)分析顯示,紅細(xì)胞(r=0.191,P0.01)、血紅蛋白(r=0.184,P0.01)、中性粒細(xì)胞(r=0.218,P0.01)、平均紅細(xì)胞血紅蛋白濃度(r=0.151,P0.01)、平均紅細(xì)胞體積(r=-0.138,P0.01)、總膽汁酸(r=-0.172,P0.01)、中性粒細(xì)胞/淋巴細(xì)胞(r=0.231,P0.01)、淋巴細(xì)胞/單核細(xì)胞(r=-0.157,P0.01)、中性粒細(xì)胞/單核細(xì)胞(r=0.121,P0.01)與三支平均血流幀數(shù)顯著相關(guān)。(3)多因素Logistic回歸分析顯示,總膽汁酸(偏回歸系數(shù)=-0.102,P0.01)、淋巴細(xì)胞/單核細(xì)胞(偏回歸系數(shù)=-0.381,P0.01)、中性粒細(xì)胞/單核細(xì)胞(偏回歸系數(shù)=0.489,P0.01)是冠狀動(dòng)脈慢血流的獨(dú)立影響因素。結(jié)論:總膽汁酸、淋巴細(xì)胞/單核細(xì)胞、中性粒細(xì)胞/單核細(xì)胞是冠狀動(dòng)脈慢血流的影響因素。
[Abstract]:Objective: to investigate the influencing factors of slow blood flow in coronary angiography. Methods: the results of coronary angiography were retrospectively analyzed in 1 530 patients who underwent coronary angiography from January 2008 to September 2010 in the affiliated Hospital of Binzhou Medical College. According to the frame number of blood flow meter after the corrected thrombolytic therapy of myocardial infarction (TIMI), a total of 139 patients with no significant coronary artery stenosis but slow coronary flow were selected as the experimental group. In the same period, 232 patients with no obvious coronary artery stenosis and normal blood flow were served as control group. Statistics of routine clinical laboratory indexes, comparison of the general conditions of the two groups, the differences of laboratory parameters, risk factors, and multi-factor Logistic regression analysis of the clinical factors of coronary artery slow blood flow. Results: (1) the age, sex, smoking history, history of diabetes, red blood cells, hemoglobin, mean hemoglobin concentration, hematocrit, neutrophils, monocytes and basophils were compared between the two groups. Lymphocytes / monocytes, neutrophils / monocytes, mean red blood cell volume, red blood cell distribution width SD, neutrophil / lymphocyte, platelet / lymphocyte, glutamic oxaloacetic transaminase, The differences of creatine kinase and total bile acid were statistically significant (P0.05). (2). The correlation analysis showed that red blood cells (r = 0.191, P0.01), hemoglobin (r = 0.184, P0.01), neutrophils (r = 0.218, P0.01), and neutrophils (r = 0.218, P0.01). Mean hemoglobin concentration (r = 0.151, P0.01), mean red cell volume (r = 0.138, P0.01), total bile acid (r = 0.172, P0.01), neutrophil / lymphocyte (r = 0.231, P0.01), mean erythrocyte hemoglobin concentration (r = 0.151, P0.01), mean red blood cell volume (r = 0.138, P0.01), total bile acid (r = 0.172, P0.01), Lymphocyte / monocyte (r = 0.157, P 0.01), neutrophil / monocyte (r = 0.121, P 0.01) were significantly correlated with the mean number of three blood flow frames. (3) Multivariate Logistic regression analysis showed that there was a significant correlation between the number of monocytes and lymphocytes / monocytes (r = 0.121, P 0.01). Total bile acid (partial regression coefficient =-0.102, P0.01), lymphocyte / monocyte (partial regression coefficient =-0.381, P0.01), neutrophil / monocyte (partial regression coefficient = 0.489, P < 0.01). P01) is an independent influencing factor of coronary slow blood flow. Conclusion: total bile acid, lymphocyte / monocyte, neutrophil / monocyte are the influencing factors of coronary artery slow blood flow.
【作者單位】： 濱州醫(yī)學(xué)院附屬醫(yī)院老年醫(yī)學(xué)科;
【基金】：山東省科技發(fā)展計(jì)劃醫(yī)藥衛(wèi)生項(xiàng)目(2013TD18019) 山東省醫(yī)藥衛(wèi)生科技計(jì)劃(2015BJYB31) 濱州市科技發(fā)展計(jì)劃(2015ZC0315)
【分類(lèi)號(hào)】：R54

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