摘要
目的分析在血栓负荷较大的急性心肌梗死(AMI)患者行急诊PCI中,应用抽吸导管对心肌再灌注的影响及安全性。方法选择经急诊冠状动脉造影显示血栓负荷较大的AMI患者36例作为血栓抽吸组,另选同期采用常规PCI的AMI患者36例作为对照组,比较2组的血栓负荷、TIMI分级、TIMI心肌灌注(TMP)分级、心肌酶峰值、ST段回落幅度、LVEF、住院期间心血管不良事件。结果血栓抽吸组患者经抽吸后血栓负荷明显降低;血栓抽吸组患者TIMI分级和TMP分级明显优于对照组,差异有统计学意义(P<0.01);血栓抽吸组患者较对照组肌酸激酶、肌酸激酶同工酶峰值明显降低,术后1 h ST段回落百分比明显增高,LVEF明显升高,左心室舒张末内径明显下降,差异有统计学意义(P<0.01)。结论在血栓负荷较重的AMI患者行急诊PCI时,应用血栓抽吸导管安全可行,可显著改善梗死相关血管前向血流情况,改善心肌再灌注,减少无复流现象和心肌酶的释放。
Objectives To investigate the effects and safety of the aspiration thrombectomy catheter on myocardial reperfusion during PCI in patients with acute myocardial infarction（AMI） with large thrombus burden. Methods Seventy-two cases with AMI undergoing emergency PCI were retrospectively studied. The patients receiving aspiration thrombectomy catheter were enrolled in thrombus aspiration group （n = 36）, and those receiving routine PCI were enrolled in control group （n = 36）. The thrombus burden of infarction-related arteries, TIMI flow grade, TMP grade, myocardial enzymes（CK, CK-MB） peak values, amplitude of ST segment fallback,left ventricular ejection fraction and adverse cardiovascular events during hospitalization between two groups were compared. ResuLts Compared with the control group,the thrombus aspiration group had significantly less thrombus burden, significantly higher TIMI grade,significantly higher TMP grade,significantly lower CK and CK-MB peak, significantly higher 1 h Sum-STR and significantly higher LVEF （P 〈 0. 01） after PCI. Conclusions Application of aspiration thrombectomy catheter during emergent PCI in patients with AMI was safe and effective, which could improve coronary flow,myocardial reperfusion and reduce myocardial damage.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2010年第10期876-878,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
血栓切除术
心肌梗死
心肌再灌注
血管成形术
经腔
经皮冠状动脉
thrombectomy
myocardial infarction
myocardial reperfusion
angioplasty, transluminal, percutaneous coronary
