急诊介入术中血栓抽吸对急性ST段抬高心肌梗死患者临床预后的研究  

Effects of thrombus-aspiration during emergency percutaneous coronary intervention in acute ST segment elevation myocardial infarction patients

作　　者：尹作民[1] 孟昭艳[1] 张成森[1] 刘翠薇[1] 

机构地区：[1]青岛市中心医院急救中心(青岛大学医学院第二附属医院),山东省266042

出　　处：《中华临床医师杂志（电子版）》2010年第5期613-617,共5页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的评价在急性ST段抬高的心肌梗死(STEMI)急诊介入术中应用血栓抽吸导管进行血栓抽吸的临床疗效。方法选择2007年10月1日至2009年9月30日在青岛市中心医院急救中心接受急诊介入治疗的STEMI患者共158例,其中急诊介入术加血栓抽吸治疗者为血栓抽吸组(n=76),同时期条件相当仅行急诊介入治疗患者作为标准经皮冠状动脉介入治疗(PCI)组(n=82),比较两组的基础资料、术后及住院和随访期间等情况。结果血栓抽吸组支架直接置入率、术后2hST段回落>50%率、冠状动脉心肌灌注分级(TMP)和校正的TIMI记帧法(CTFC)血流均明显优于标准PCI组;发病后24h肌酸激酶同工酶(CK-MB)值与B型尿钠肽(BNP)值显著低于标准PCI组,术后1个月左心室射血分数(LVEF)改善不明显。结论 STEMI急诊介入术中血栓抽吸治疗安全可靠,增加心肌水平的血流灌注,减少坏死心肌数量,可以改善STEMI近期预后。Objective To evaluate the effect of thrombus-aspiration during emergency percutaneous coronary intervention ( PCI) in patients with acute ST segment elevation myocardial infarction( STEMI). Methods The STEMI patients underwent emergent PCI from 1 October 2007 to 30 September 2009,76 patients received aspiration thrombectomy were enrolled in study group,and those 82 patients who only received routine PCI were enrolled in control group. The clinical data,information after operation and the follow-up data were compared between the tow groups. Results Compared with control group,thrombus aspiration group had more direct stent and faster ST segment resolution. The study group had significantly improved TMP and CTFC,lower serum CK-MB and BNP level. But the diffierences in LVEF were not significant. Conclusions Thrombus-aspiration was safe and effective,and had good immediate effects during emergency PCI with STEMI,which could improve myocardium perfusion and reduce myocardial necrosis.

关 键 词：心肌梗死 血管成形术 经腔 经皮冠状动脉 急诊处理 抽吸 

分 类 号：R542.22[医药卫生—心血管疾病]