目的探究急性冠脉综合征(ACS)经皮冠脉介入(PCI)治疗后无复流现象及发生支架内再狭窄的相关危险因素。方法收集2016年4月至2016年10月收治的接受PCI治疗的136例ACS患者的临床资料,根据管腔狭窄情况分为甲组(冠脉无狭窄组)和乙组(冠脉狭窄组),根据冠状动脉造影(TIMI)血流分级标准分为丙组(血流正常组)和丁组(无复流组)。采用单因素和多因素Logistic逐步回归分析无复流现象与发生支架内再狭窄的相关危险因素。结果单因素分析显示,乙组吸烟、糖尿病史、心肌梗死、脑卒中、高脂血症的发生率显著高于甲组(P<0.05,P<0.01),血小板计数、心功能Killip分级以及术前狭窄程度均显著高于甲组(P均<0.01),两组间临床诊断分布差异有统计学意义(P<0.01)。丁组糖尿病史、心肌梗死、脑卒中、白细胞增多的发生率显著高于丙组(P<0.05,P<0.01),血小板计数、心功能Killip分级、术前狭窄程度、支架直径以及支架长度也均显著高于丙组(P<0.05,P<0.01),两组间临床诊断和冠脉病变部位分布差异有统计学意义(P均<0.05);多因素Logistic逐步分析显示,吸烟、术前狭窄程度和临床诊断为支架内再狭窄的影响因素;糖尿病史、白细胞增多、术前狭窄程度、心功能Killip分级>2级为无复流现象的影响因素。结论吸烟、术前狭窄程度越高以及临床诊断为不稳定性心绞痛和非ST段抬高心肌梗死均是支架内再狭窄的独立危险因素,而糖尿病史、存在白细胞增多、术前狭窄程度高、心功能Killip分级>2级均是无复流现象的独立危险因素。 Objective To investigate the risk factors of no-reflow phenomenon and in-stent restenosis after percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS). Methods The clinical data of 136 patients with ACS undergoing PCI from April 2016 to October 2016 were collected and divided into group A (group without coronary artery stenosis) and group B (group with coronary artery stenosis) according to the condition of stenosis. According to the standard of coronary angiography (TIMI), they were divided into group C (normal blood flow group) and group D (no-reflow group). Univariate and multivariate Logistic stepwise regression analysis of no-reflow phenomenon and the occurrence of in-stent restenosis associated risk factors. Results Univariate analysis showed that the incidence of smoking, history of diabetes, myocardial infarction, stroke and hyperlipidemia in group B was significantly higher than that in group A (P <0.05, P <0.01), platelet count, Killip classification of heart function The degree of anterior stenosis was significantly higher than that of group A (P <0.01). There was significant difference in clinical diagnosis between the two groups (P <0.01). The incidence of diabetes mellitus, myocardial infarction, stroke and leukocytosis in group D was significantly higher than that in group C (P <0.05, P <0.01). Platelet count, Killip classification, preoperative stenosis, stent diameter and stent length (P <0.05, P <0.01). There was significant difference between the two groups in the clinical diagnosis and the distribution of coronary lesions (P <0.05). The multivariate Logistic stepwise analysis showed that smoking, preoperative Stenosis and clinical diagnosis of in-stent restenosis factors; history of diabetes mellitus, leukocytosis, preoperative stenosis, cardiac function Killip grading> 2 factors for the no-reflow phenomenon. Conclusions Smoking, the preoperative stenosis and the clinical diagnosis of unstable angina pectoris and non-ST-segment elevation myocardial infarction are both independent risk factors for in-stent restenosis. However, the history of diabetes mellitus, leukocytosis, preoperative stenosis, Cardiac function Killip grading> Grade 2 are independent risk factors for no-reflow phenomenon.