Study On The Related Risk Factors Of Slow Blood Flow-no Reflow Phenomenon During Emergency PCI In Patients With ACS In Qinghai

Objective: To analyze the related risk factors of slow blood flow and no reflow phenomenon during emergency PCI in patients with ACS in Qinghai.Methods: A retrospective analysis of the clinical data of 310 patients with acute coronary syndrome treated with ACS in the catheterization room of Qinghai Red Cross Hospital from October 2016 to September 2019.Coronary angiography was performed in both groups of patients,usually by Judkins method,to assess coronary artery disease,and to group patients according to TIMI blood flow classification.If the patient's TIMI blood flow classification is ? 2 level,it is slow blood flow or no blood flow.In the reflow group,if the patient's TIMI blood flow classification is> 2 level,it is extremely normal blood flow control group.Data collection was performed for each group of patients,including general clinical data,laboratory indicators,coronary angiography results,and echocardiographic results.Results: After grouping according to blood flow classification,a total of 31 patients in the slow-flow-no-reflow group and the remaining 279 were in the normal-flow group.Comparing the general information of the two groups of patients,there were significant differences between the patients with slow blood flow and no reflow group and those with normal blood flow who were smoking or smoking within one year,,and stent placement.The number of patients with clinical data was significantly higher than that of the normal blood flow group,P <0.05,the differences were statistically significant;the remaining age,gender,height,weight and other related clinical data were not significantly different,P> 0.05,the differences were all No statistical significance.Comparing the laboratory examination index levels of the two groups of patients,there were significant differences in the TG detection value and the time of the first detection of blood uric acid in the slow blood flow-non-reflow group and the normal blood flow group.The TG test value of the patients in the group was significantly lower than that in the normal blood flow group,and the value of the first detection time of blood uric acid in the patients with slow blood flow and no reflow was significantly higher than that in the normal blood flow group,P <0.05,and the differences were statistically significant;The remaining levels of troponin,creatinine,hemoglobin,and other indicators at the time of first detection were not significantly different,P> 0.05,and the differences were not statistically significant.The coronary angiography results of the two groups of patients were compared.There were significant differences in the total length of stent used during the operation of the slow-flow-free-flow group and the normal-flow group,the amount of contrast agent,and the onset-balloon time.The total length of stent used in the blood flow-non-reflow group during surgery,onset-balloon time were significantly higher than those in the normal blood flow group,and the amount of contrast agent in the slow-flow-non-reflow group was significantly higher than the normal blood flow.Group,P <0.05,the differences were statistically significant;the remaining total stent length used during surgery,number of stent used during surgery,number of stent used during surgery and other indicators were not significantly different,P> 0.05 The differences were not statistically significant.There were significant differences in the types of lesions between the slow-flow-free-flow group and the normal-flow group,P <0.05,and the difference was statistically significant.After comparing the clinical medications of the two groups of patients,it was found that there was no significant difference in the clinical dosages of the two groups of patients,P> 0.05,the difference was statistically significant.By comparison,the left ventricular end-diastolic diameter and other echocardiographic results of patients in the slow-flow-no-reflow group and those in the normal-flow group were not statistically significant.Multivariate analysis results showed that smoking or smoking within one year,history of hyperthyroidism,stent placement,TG detection value,blood uric acid first detection time detection value,total length of stent used during surgery;amount of contrast agent,onset-balloon time were The independent risk factors of slow blood flow and no reflow,P <0.05,the difference was statistically significant.Conclusion: There are many factors that affect the occurrence of slow blood flow-no reflow in patients with ACS,including the amount of contrast agent,smoking history,stent placement and lesion type,TG detection value,blood uric acid first detection time detection value,etc.,based on the above factors The potential threats associated with PCI surgery are avoided to reduce the risk of patients with slow blood flow-no reflow,and to ensure the safety of clinical treatment of patients.