Percusurge远端保护装置在急性ST段抬高心肌梗死介入治疗中的应用  

Use of Percusurge guardwire system in coronary intervention with ST elevation myocardial infarction

作　　者：冯旭阳[1] 徐瑞芬 李成祥[1] 王海昌[1] 郭文怡[1] 张清[1] 曹艳杰[1] 王晓燕[1] 

机构地区：[1]第四军医大学西京医院心脏内科,西安710032 [2]第四军医大学口腔医院麻醉科

出　　处：《临床心血管病杂志》2006年第12期732-734,共3页Journal of Clinical Cardiology

摘　　要：目的:评价Percusurge远端保护装置(DPD)在急性ST段抬高心肌梗死(STEMI)患者冠状动脉介入治疗中的有效性及安全性。方法:104例接受急诊PCI治疗的STEMI患者分2组,DPD组48例,对照组56例。比较2组间的基础临床状况、造影情况、介入治疗结果。病变血管术后均行TIMI分级、TIMI计帧。结果:DPD组48例全部抽出肉眼可见的红色、白色碎屑或红色血栓条。2组间的基础临床状况、术前造影情况均差异无统计学意义。但DPD组与对照组间术后TIMI2～3级为91..7%和76.8%(P<0.05),发生无复流现象为4.2%和16.1%(P<0.05);远端小血管栓塞为8.3%和23.2%(P<0.05);2组的TIMI帧数为20.2±2.8和31.2±4.4(P<0.05);住院期间均无主要心血管事件发生。结论:PercusurgeDPD能有效保护远端血管,吸出冠状动脉内血栓,避免远端血管栓塞。该方法无严重并发症发生,在急性心肌梗死等冠状动脉内存在大量血栓的情况下行介入治疗时具有良好的治疗效果。Objective： To evaluate the efficiency and safety of Percusurge guardwire distal protection derice （DPD） in coronary intervention in patients with acute myocardial infarctionl of ST elevation STEMI. Method： From June 2003 to March 2005, there were 104 acute STEMI patients who received primary coronary intervention in this study. Patients were divided into DPD group and control group according to whether Percusurge DPD was attempted during emergency PCI. The basic clinical characteristics, angiographic results, and follow up data before discharge were compared. TIMI grade and TIMI Frame Count were performed in all cases after emergency PCI. Result：Success was achieved in 48 patients by Percusurge DPD with varies extent of material from the basket. There was no significant difference between the two groups in basic clinical characteristics and angiogram before PCI. After PCI, DPD group showed an improvement compared with control group in TIMI 3 flows （91.7 ： 76.8 %, respectively P〈0.05）, no flow（4.2% ： 16.1 %,respectively;P〈0.05）, distal embolizations respec tively（8.3 % ： 23.2 % ,respectively; P〈0.05）and TIMI frame count（20.2±2.8 ： 31.2±4.4,respectively; P〈0.05）. There was no main cardiovascolar events in both groups. Conclusion：Percusurge guardwire system can be used safely and effectively in coronary intervention in the thrombus laden arteries with acute myocardial infarction.

关 键 词：心肌梗死 冠状动脉介入治疗 Percusurge远端保护装置 

分 类 号：R542.2[医药卫生—心血管疾病]