绝经后内源性雌激素水平与急性ST段抬高型心肌梗死患者心肌再灌注后无复流的关系

发布时间：2018-02-13 20:26

  本文关键词： 心肌梗死 雌激素类 无复流　出处：《中国循环杂志》2017年06期 　论文类型：期刊论文

【摘要】：目的:探讨绝经后内源性雌激素水平与急性ST段抬高型心肌梗死(STEMI)患者心肌再灌注后无复流的关系。方法:共纳入绝经后女性STEMI行急诊经皮冠状动脉介入治疗(PCI)的患者100例,根据心肌再灌注后有无复流发生分为复流组77例和无复流组23例。心肌无复流定义为心肌再灌注后心肌梗死溶栓治疗临床试验(TIMI)血流≤2级或TIMI血流3级且心肌呈色分级(MBG)≤2级。所有患者均术前抽血检测内源性性激素水平。Logistic回归分析内源性性激素水平与心肌再灌注后无复流之间的关系。结果 :与复流组相比,无复流组雌酮、雌二醇和高敏C-反应蛋白(hs-CRP)水平明显升高(P0.05),而性激素结合球蛋白(SHBG)水平则降低(P0.05)。单因素分析结果提示病灶长度、血栓负荷评分≥4分、雌酮、雌二醇和hs-CRP水平与心肌再灌注后无复流发生呈正相关(P0.05)。进一步的多因素Logistic回归分析表明血栓负荷评分≥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)是心肌再灌注后无复流发生的独立危险因素。结论 :在绝经后女性STEMI患者中,高水平内源性雌二醇和心肌再灌注后无复流的发生呈正相关,提示内源性雌二醇可能是心肌再灌注后无复流发生的独立危险因素。
[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，

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