实用医学杂志2023年第39卷第17期TheJournalofPracticalMedicine2023Vol.39No.17老年急性前壁心肌梗死急诊经皮冠脉介入术后早期左心室血栓形成的预测因素呼日乐巴特尔吴红丽刘雪婷李志鹏杨志鹏王洪军辛琦陈宏魏内蒙古民族大学附属医院心血管内科（内蒙古通辽028000）【摘要】目的探讨老年急性前壁心肌梗死患者急诊经皮冠脉介入术（percutaneouscoronaryintervention，PCI）后早期左心室附壁血栓（leftventricularthrombus，LVT）的预测因素。方法连续入选2020年1月至2023年1月就诊于我院，行急诊PCI老年前壁心肌梗死患者435例，住院期间发现LVT形成40例为LVT组，从非LVT患者中按照性别和年龄1∶2匹配80例患者为非LVT组，最终120例患者纳入本研究。探讨LVT的危险因素，分析LVT的预测因素。结果LVT发生率为9.2%，出院时持续ST段抬高、左心室射血分数（leftventricularejectionfraction，LVEF）≤0.40、室壁瘤、症状发作至球囊扩张时间（symptomtoballoom，STB）≥8h、术后TIMI血流<3级和D-二聚体/纤维蛋白原比值（D-dimertofibrinogenratio，DFR）升高是LVT形成的危险因素（P<0.05）。ROC曲线分析显示DFR≥0.30对LVT预测的敏感度为72.5%，特异度为78.7%（AUC=0.834，P<0.01）。结论出院时持续ST段抬高、LVEF≤0.40、室壁瘤、STB≥8h、术后TIMI血流<3级和DFR升高是早期LVT形成的独立预测因素。DFR对LVT具有良好的预测价值。【关键词】老年；急性前壁心肌梗死；左心室血栓形成；D-二聚体/纤维蛋白原比值【中图分类号】R54PredictorsofearlyleftventricularthrombusinelderlypatientswithanterioracuteSTsegmentelevationmyocardialinfarctionreceivingemergencypercutaneouscoronaryinterventionHurilebater，WUHongli，LIUXueting，LIZhipeng，YANGZhipeng，WANGHongjun，XINQi，CHENHongwei.DepartmentofCardiovascu⁃larMedicine，theAffiliatedHospitalofInnerMongoliaUniversityforNationalities，Tongliao028000，China【Abstract】ObjectiveToexplorethepredictivefactorsofearlyleftventricularmuralthrombus（LVT）afteremergencyPCIinelderlypatientswithacuteanteriormyocardialinfarction.MethodsAtotalof435elderlypatientswithanteriormyocardialinfarctionwhounderwentemergencyPCIinourhospitalfromJanuary2020toJanuary2023werecontinuouslyincludedinthestudy.FortypatientswithLVTformationduringhospitalizationwereselectedasLVTgr...
