Analysis Of Related Factors Of Coronary Slow Flow Phenomen On During Perioperative Period

Background Coronary slow flow phenomenon(CSFP)refers to the phenomenon that although there is no obvious stenosis of epicardial vessels,the perfusion of contrast media is slow and the distal flow is delayed;At present,there is no clear consensus on its pathogenesis,etiology and treatment.The purpose of this study was to analyze the risk factors and potential predictors of perioperative CSFP.Method According to the criteria of inclusion and exclusion,91 normal blood flow patients and 90 CSFP patients were selected from the normal blood flow group who underwent coronary angiography in the people’s Hospital Affiliated to Nanchang University;The clinical data of perioperative period were collected and analyzed statistically.The difference between groups of classification variables was analyzed by chi square test;The continuous variables which obey normal distribution are analyzed by independent sample t test,while Mann Whitney U test is used for non-conforming normal distribution.The independent risk factors of CSFP were determined by multi factor Logistic regression model;Spearman correlation coefficient is used to identify whether there is correlation between correlation variables and their correlation degree.In order to further explore the factors affecting the whole slow blood flow of the heart vessels,logistic ordered regression analysis was carried out to find the index to aggravate the severity of slow blood flow.Finally,ROC curve is constructed to explore the sensitivity and specificity of various factors and determine the best critical value.Result In our study population,the proportion of males in CSFP patients was more and smoking rate was higher.In clinical blood test data,the indicators of white ball ratio,glutathione,homocysteine,creatinine,urea nitrogen,uric acid,NT pro BNP,RBC count,hemoglobin,hematocrit were higher than that of the normal control group,while platelet count was lower than that of normal group;There was no difference between the two groups in the use of contrast medium,but there was more use of idksartal in CSFP and more in the normal control group.Logistic regression analysis showed that the white ball ratio,uric acid,hemoglobin,pro BNP,platelet count,smoking and so on were independent risk factors for CSFP.The prediction performance of each index to CSFP was analyzed by ROC curve.The critical value of uric acid was 326.5umol/l,sensitivity 65.6%,specificity 60.4%,P < 0.001;The critical value of white ball ratio was 1.51,sensitivity was 32.2%,specificity was86.6%,P = 0.007;The critical value of hemoglobin was 133.5g/l,the sensitivity was66.7%,specificity was 57.1%,P = 0.001;The critical value of NT pro BNP is 396.5pg/ml,sensitivity is 55.6%,specificity is 70.3% P=0.003;The sensitivity of smoking was 40.0%,and the specificity was 86.8% P = 0.002;Platelet count has no predictive significance for CSFP.Conclusion The findings of this study show that: WBR,uric acid,hemoglobin,NT pro BNP and smoking are independent predictors of CSFP,WBR,uric acid,hemoglobin and NT pro BNP levels are higher than those of normal blood flow group,among which WBR,uric acid,hemoglobin and smoking are positively correlated with overall blood flow degree,and smoking is an independent risk factor for the severity of blood flow in patients with CSFP.The mechanism may be related to coronary atherosclerosis and vascular endothelial injury.