To Explore The Clinical Factors Affecting Myocardial Microcirculatory Perfusion Disorder After PPCI For STEMI

Objective: To explore the related factors of myocardial microcirculation perfusion disorder after emergency percutaneous coronary intervention for acute ST-segment elevation myocardial infarction.Research objects and methods:STEMI patients with TIMI blood flow grade 3 after emergency PCI who were hospitalized in First Affiliated Hospital of Dalian Medical University from January 2017 to December 2018 were examined by myocardial contrast echocardiography(MCE)within 48 hours after revascularization,and their contrast score index(CSI)was counted to evaluate the coronary artery microcirculation.Relevant data of patients were collected,including cardiovascular related risk factors(age,sex,smoking,hyperlipidemia,diabetes,hypertension),admission test related indicators(troponin?white blood cells,homocysteine,creatinine,),infarct related artery(IRA)(lesion site,lesion degree),operation related data(symptom onset to balloon dilation time(SO-B),balloon dilation times,balloon dilation time,and balloon dilation maximum pressure).Multivariate Logistic regression analysis was used to investigate the independent risk factors of myocardial microcirculation perfusion disorder in STEMI patients after emergency PCI.The difference was statistically significant(P<0.05).The statistical software adopts SPSS16.0 software package.Results:1.common cardiovascular related risk factors such as sex,age,smoking,4.the number of balloon expansions,the time of balloon expansions and the maximum pressure of balloon expansions are not statistically different from myocardial microcirculation perfusion after STEMI emergency PCI(P>0.05),but the time from symptom onset to balloon expansions is statistically different(P<0.05),and is negatively correlated with myocardial perfusion.5.Multivariate Logistic regression analysis showed that the time from symptom onset to balloon dilatation,white blood cells in admission blood routine were independent risk factors for myocardial microcirculation perfusion disorder after emergency PCI for STEMI patients.2.Related indexes of admission test diseases: homocysteine and creatinine have no statistical difference with myocardial microcirculation perfusion after STEMI emergency PCI(P>0.05),while white blood cell count and troponin calculation have statistical difference(P<0.05),and they are all negatively correlated with myocardial perfusion.3.there was no statistical difference between the lesion site and degree and myocardial microcirculation perfusion after STEMI emergency PCI(P>0.05).hyperlipidemia,diabetes,hypertension,etc.have no statistical difference with myocardial microcirculation perfusion after STEMI emergency PCI(P>0.05).Conclusion: 1.For the first aid of STEMI patients,the total myocardial ischemia time should be shortened to the greatest extent and PCI should be effectively prevented The occurrence of postoperative myocardial microcirculation perfusion disorder can reduce the incidence of adverse prognosis such as postoperative cardiac insufficiency.2.Myocardial microcirculatory perfusion can affect cardiac function of patients after PCI.White blood cell counts are correlated with myocardial microcirculation,which can be used as a reflection of cardiac function after myocardial reperfusion and have positive significance for early clinical prognosis evaluation.