CAJ | 학술논문

目的探讨急性心肌梗死(AMI)患者静脉溶栓再灌注效果与冠状动脉病变影像学特征即冠脉病变支数、梗死相关动脉(infarct-related artery,IRA)分布部位、形态、狭窄程度与长度)的相关性.方法收集2001年1月至2007年8月在广西医科大学第一附属医院心血管病研究所住院且行尿激酶静脉溶栓的84例AMI患者资料进行回顾性分析.采用单因素与多因素方法分析冠脉造影病变特征即病变支数、IRA分布部位、形态改变、狭窄程度和长度等因素与再通是否相关.结果按间接再通指征判断再通率为64.29%.单因素检验显示IRA狭窄长度、及分布部位,均进入回归方程(P值均＜0.05),病变支数及IRA狭窄程度未能进入回归方程(P＞0.05).多因素logistic回归分析结果提示尿激酶溶栓再通与IRA狭窄长度患者呈负相关;与IRA分布部位相关性无统计学意义(P＞0.05).结论 (1)AMI患者静脉尿激酶溶栓再通效果与IRA狭窄长度呈负相关;(2)冠脉病变支数、IRA分布部位及IRA狭窄程度等因素与再通效果无统计学意义相关性.
목적 탐토급성심기경사(AMI)환자정맥용전재관주효과여관상동맥병변영상학특정즉관맥병변지수、경사상관동맥(infarct-related artery,IRA)분포부위、형태、협착정도여장도)적상관성.방법 수집2001년1월지2007년8월재엄서의과대학제일부속의원심혈관병연구소주원차행뇨격매정맥용전적84례AMI환자자료진행회고성분석.채용단인소여다인소방법분석관맥조영병변특정즉병변지수、IRA분포부위、형태개변、협착정도화장도등인소여재통시부상관.결과 안간접재통지정판단재통솔위64.29%.단인소검험현시IRA협착장도、급분포부위,균진입회귀방정(P치균＜0.05),병변지수급IRA협착정도미능진입회귀방정(P＞0.05).다인소logistic회귀분석결과제시뇨격매용전재통여IRA협착장도환자정부상관;여IRA분포부위상관성무통계학의의(P＞0.05).결론 (1)AMI환자정맥뇨격매용전재통효과여IRA협착장도정부상관;(2)관맥병변지수、IRA분포부위급IRA협착정도등인소여재통효과무통계학의의상관성.
Objective To evaluate the angiographic findings and the therapeutic effect of thrombolysis in AMI (acute myocardial infarction) patients. Method A retrospective study were carried out in consecutive eighty-four inpatients with AMI treated with intravenous thrombolysis and coronary angiography was taken within a week after illness onset from January 2000 to August 2007. The patients were divided into successful recanalization group and non-recanalization group. Single factor χ2 test and multi-factor logistic regression analysis were applied to observe the relationship among the angiographic features of IRA (infarct-related artery including the number of stnosis, the location of stenosis, the severity of stenosis and the morphological changes) and treatment effect of intravenous urokinase thrombolysis. Results (1) Single factor χ2 test showed that location and the extent of lesion of IRA were eligible to enter the logistic regression formula (P ＜ 0.05),whereas the number of lesions and the severity of IRA's stenosis were not eligible to enter the logistic regression formula (P ＞ 0. 05). (2) Multi-factor logistic regression analysis showed that the extent of lesion of IRA was the only factor that had a negative impact on the therapeutic effect of intravenous thrombolysis.Conclusions The study shows that the extent of lesion of IRA is the only factor that has a negative impact on the therapeutic effect of intravenous thrombolysis; The number, the location of lesion and the severity of stenosis of IRA have no impact on the therapeutic effect of intravenous thrombolysis in AMI.