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目的:分析在ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者的急性期,梗死相关血管内血栓高负荷的相关因素。方法:195例发病时间在12 h以内行急诊经皮冠脉介入(PCI)术的STEMI患者,根据冠脉造影结果分为高血栓负荷组(n=84)和低血栓负荷组(n=111)。受试患者入院急查高敏C反应蛋白(high-sensitivity C-reactive protein,hs-CRP),白介素-6(interleukin-6,IL-6),可溶性细胞内黏附分子1(soluble intercel-lular cell adhesion molecule-1,sICAM-1),P选择素(p selectin,PS)和白细胞(white blood cell,WBC)计数。结果:高血栓负荷组PS、CK-MB峰值和WBC水平显著高于低血栓负荷组[(14±8)μg/Lvs.(8±4)μg/L;(42±52)μg/Lvs.(34±39)μg/L;(11±4)×109/Lvs.(10±3)×109/L,均P<0.05)。Logistic回归分析PS(OR=1.259,95%CI1.125-1.408,P<0.01)是血栓负荷独立的相关因素。结论:PS是STEMI患者闭塞血管高血栓负荷的独立相关指标。
OBJECTIVE: To analyze the related factors of acute myocardial infarction-related endovascular stent thrombosis in patients with ST-segment elevation myocardial infarction (STEMI). Methods: A total of 195 patients with STEMI undergoing emergency percutaneous coronary intervention (PCI) within 12 hours of onset were divided into high thrombus loading group (n = 84) and low thrombus loading group (n = 111) ). The patients were admitted to hospital for acute high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), soluble intercel- lular cell adhesion molecule-1, sICAM-1), P selectin (PS) and white blood cell (WBC). Results: The peak values of PS, CK-MB and WBC in high thrombosis group were significantly higher than those in low thrombosis group [(14 ± 8) μg / L vs (8 ± 4) μg / L and (42 ± 52) μg / Lvs). (34 ± 39) μg / L; (11 ± 4) × 109 / L vs (10 ± 3) × 109 / L, all P <0.05). Logistic regression analysis of PS (OR = 1.259,95% CI1.125-1.408, P <0.01) was an independent factor related to thrombus burden. CONCLUSIONS: PS is an independent and independent marker of occlusion vascular thrombosis in patients with STEMI.