血栓抽吸联合PCI术前阿托伐他汀强化治疗急性ST段抬高型心肌梗死  

Combination of Thrombectomy Catheter and PCI-preoperative Atorvastatin Treatment for Acute ST-segment Elevation Myocardial Infarction

作　　者：郑志刚[1] 贺铿[1] 李莺[1] 石刚[1] 叶君明[1] 

机构地区：[1]南方医科大学附属萍乡医院,江西萍乡337055

出　　处：《现代生物医学进展》2012年第30期5848-5850,5854,共4页Progress in Modern Biomedicine

摘　　要：目的:探讨急性ST段抬高型心肌梗死急诊经皮冠状动脉介入治疗(PCI)中应用GOODMAN血栓抽吸装置联合术前阿托伐他汀强化治疗对心肌组织灌注及临床预后的影响。方法:选择梗死相关血管心肌梗死溶栓试验血流0级的急性ST段抬高型心肌梗死患者80例,随机分为血栓抽吸联PCI术前阿托伐他汀强化治疗组(试验组)40例和标准PCI治疗组(对照组)40例。比较两组患者术后心肌梗死溶栓试验(TIMI)血流分级、TIMI心肌灌注分级(TMPG)、心电图ST段回落百分比、左心室射血分数(LVEF)及住院期间主要心血管不良事件(MACE)。结果:试验组TIMI血流分级、TMPG、ST段回落百分比、LVEF均明显优于对照组(P<0.05)。两组患者住院期间MACE发生率比较,差异无统计学意义(P>0.05)。结论:在急性ST段抬高型心肌梗死急诊经皮冠状动脉介入治疗(PCI)中应用血栓抽吸联合术前阿托伐他汀强化治疗安全可行,可有效清除冠状动脉内血栓,改善心肌组织灌注及术后心脏功能,并且不增加主要心血管事件的发生率。Objective： To assess the effect of the GOODMAN aspiration thrombectomy catheter and Atorvastatin in the myocardial reperfusion and clinical prognosis of patients with acute ST-segment elevation myocardial infarction （AMI）who undergone percutaneous coronary intervention （PCI）. Methods： 80 patients of AMI with intra-infarct-related artery thrombolysis in myocardial infarction （TIMI） flow grade 0 confirmed by coronary angiography were randomly divided into the aspiration catheter and Atorvastatin group（experiment group, n=40） and standard percutaneous coronary intervention（PCI）group（ control group, n=40）. Compared the T1MI flow grade, TIMI myocardial perfusion grade（TMPG）, ST segment resolution, left ventrieular ejection fi-action（LVEF） post PCI and major adverse cardiac events （MACE）rate during hospitalization between two groups. Results： Compared with control group, TIMI flow grade, TMBG, ST segment resolution and LVEF were improved in experiment group （P〈0.05）, while the difference of MACE rate during hospitalization showed no statistical significance （P〉0.05）. Conclusion： In AMI patients treated with primary PCI, the combination of thrombus aspiration and preoperative Atorvastatin regimen was safe and effective, and could lower thrombosis burden, improve distal myocardium perfusion and postoperative cardiac function. It yet does not increase the incidence of MACEs.

关 键 词：心肌梗死 经皮冠状动脉介入治疗 血栓抽吸 阿托伐他汀 

分 类 号：R542.22[医药卫生—心血管疾病]