| Objective: In this study,Meta-analysis was used to evaluate the common influencing factors and associated intensity of non-reflow in patients with acute myocardial infarction.The main factors included:(1)neutrophil / lymphocyte ratio(NLR);(2)Combined with type2 diabetes mellitus;(3)Combined with low blood pressure;(4)onset-reperfusion time prolonged;(5)no collateral circulation;(6)thrombosis load;(7)hs CRP increased;(8)multi-stent placement;(9)multiple lesions,Comprehensive analysis of the above-mentioned risk factors and the occurrence of no-reflow correlation,for the non-reflow prediction and prevention to provide a reliable evidence-based basis.Methods:The Cochrane Collaboration in strict accordance with the requirements of the literature search,through Pubmed,Springer,Cochrane,Science Citation Retrieval(SCI),Embase,Medline,CNKI,Wanfang,VIP and other database-related emergency PCI in patients with acute myocardial infarction no-reflow surgery Related risk factors for online retrieval,as far as possible to collect a comprehensive study of the literature,the search time range from January 2002 to January 2017,the language limit limited to Chinese and English.Meta-analysis was used to analyze the included literature.The results showed that the odds ratio(OR)was used as the categorical variable effect,95% CI was the range of the effect,and the heterogeneity was analyzed by Q test.Eventually included in the clinical common 9 and no recurrence associated with the risk factors:(1)neutrophil /lymphocyte ratio(NLR);(2)Combined with type 2 diabetes mellitus;(3)Combined with low blood pressure;(4)onset-reperfusion time prolonged;(5)no collateral circulation;(6)thrombosis load;(7)hs CRP increased;(8)multi-stent placement;(9)multiple lesions,The valuable raw data into the test data,and finally using Rev Man 5.3 statistical software for meta-analysis.Results: According to the inclusion criteria,20 articles on the risk factors of no-reflow were included,including 8 Chinese articles and 12 articles in English.Meta analysis results are as follows:1.NLR value: the combined effect of OR value of 1.27,95% CI(0.89,1.66),P <0.05.2.Combination of type 2 diabetes: the combined effect of OR value of 14.77,95% CI(11.50,18.98),P <0.05.3.Combination of hypotension: combined effect of OR value of 10.00,95% CI(5.06,19.77),P <0.05.4.Incidence-reperfusion time: the combined effect of OR value of 4.94,95% CI(4.70,5.18),P <0.05.5.No collateral circulation: the combined effect of OR value of 17.22,95% CI(13.87,21.39),P <0.05.6.Thrombus load: the combined effect of OR value of 13.94,95% CI(10.24,18.99),P<0.05.7.hs CRP: The combined effect OR was 10.57,95% CI(9.93,11.20),P <0.05.8.Multiple stent implantation: The combined effect OR was 13.89,95% CI(10.27,18.77),P <0.05.9.Multiple lesions: the combined effect of OR value of 7.83,95% CI(6.28,9.75),P <0.05.Conclusion:At present,there is no definite conclusion on the etiology and pathogenesis of no-reflow.In this study,it is considered that the neutrophil / lymphocyte ratio(NLR),combined with type 2 diabetes mellitus,Combined with low blood pressure,onset-reperfusion time prolonged,no collateral circulation,thrombus load,hs CRP increased,multi-stent placement,multi-vessel disease in patients with acute myocardial infarction occurred in the emergency PCI Factors,the above risk factors and no-reflow associated strength from strong to weak followed by: no collateral circulation,combined with type 2 diabetes,thrombus load,multi-stent placement,hs CRP,combined with hypotension,multi-vessel disease,Perfusion time,NLR.Clinical use of the above conclusions can be used to predict and prevent the occurrence of no-reflow,in order to cope with the occurrence of no-return flow to provide space. |
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