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目的:明确急性心肌梗死(AMI)并糖尿病冠状动脉介入治疗(PCI)前药物干预是否可以有效预防PCI过程中无复流现象。方法:首先将入选患者按照PCI是否出现无复流分为无复流组和正常血流组,然后对药物干预情况、生化、PCI情况等进行Logistic分析,明确药物干预与无复流的关系。结果:他汀类药物是AMI并糖尿病行PCI出现无复流的保护因子[χ2=9.360,P=0.002,Exp(B)=0.309),服用时间≥3个月的无复流发生率明显降低(3.8%,10.9%,χ2=5.413,P=0.020)。而血管紧张素转化酶抑制剂类、β受体阻滞剂、阿司匹林对无复流的发生无明显影响(P>0.05)。结论:长期服用他汀类药物可以减少AMI并糖尿病PCI中无复流的发生。
OBJECTIVE: To determine whether drug intervention in patients with acute myocardial infarction (AMI) and coronary artery disease (PCI) before diabetes mellitus can effectively prevent no-reflow during PCI. Methods: Firstly, the patients were divided into no-reflow group and no-reflow group according to whether PCI occurred. Then the Logistic analysis of drug intervention, biochemistry and PCI were made to confirm the relationship between drug intervention and no-reflow. Results: Statins were protective factor for no-reflow in PCI with AMI and diabetes (χ2 = 9.360, P = 0.002, Exp (B) = 0.309) 3.8%, 10.9%, χ2 = 5.413, P = 0.020). Angiotensin converting enzyme inhibitors, β-blockers and aspirin had no significant effect on the occurrence of no-reflow (P> 0.05). CONCLUSION: Long-term statin use reduces AMI and no-reflow in diabetic PCI.