血栓抽吸导管对心肌梗死患者心肌微灌注的影响  

作　　者：张荣华[1] 杨锋[2] 吕云[1] 刘屹[1] 卢竞前[2] 

机构地区：[1]云南省个旧市人民医院心内科,云南661000 [2]昆明市第一人民医院心内科,650011

出　　处：《当代医学》2013年第27期71-72,共2页Contemporary Medicine

摘　　要：目的评价在急性sT段抬高型心肌梗死（sTEMI）急诊经皮冠状动脉介入（PcI）中应用血栓抽吸导管对心肌微灌注和近期预后的影响。方法选择2010年2月-2012年7月在个旧市人民医院心内科接受急诊PCI并使用血栓抽吸导管治疗的STEMI患者，根据是否使用抽吸导管分为急诊PCI组（A组，42例）和急诊PCI中使用抽吸导管组（B组，54例）。比较组间的基础资料、术后心肌灌注情况和随访情况。结果两组问基础和临床资料相似；A组在无复流或慢血流方面较B组明显高，差异有统计学意义（23.8％比3．7％，P〈0.05）。B组比A组可显著改善cTFC帧数[（26．45±3.62）比（55.78±4.95），P〈0.05]，B组比A组可显著改善MBG2～3级情况（87％比73％，p〈0．05）。结论血栓抽吸导管在sTEMi急诊PCI中安全可行，可以改善心肌灌注水平，从而有助于改善临床预后。Objective To evaluate the influences of myocardium perfusion and clinical outcomes use aspiration thrombectomy catheter during emergency percutaneous coronary intervention （PCI） for the patients with acute ST segment elevation myocardial infarction （STEMI）. Methods The patients undergoing emergent PCI and using aspiration thrombectomy catheter with STEMI from February 2010 to 2012 June were enrolled into the study group. According to the aspiration use, they were divided into 2 groups： only PCI group （group A,n = 42） and aspiration with PCI group （group B,n =54）. The baseline profiles, myocardium perfusion and follow-up data were compared. Results No significant baseline differences existed among 2 groups. Compared with group A, group B had less No-flow patients（23.8% vs 3.7% ,P〈 0.05）. A group had higher cTFC than B group [（26.43±3.62 vs （33.78±4.95）, P〈 0.05], lower MBG 2-3 grade level（87% vs 73%, P〈 0.05）. Conclusion Application of aspiration during emergent PCI is safe and efficacious for STEMI patients. It may improve myocardium perfusion ,thus have better clinical outcome.

关 键 词：心肌梗死 血管成形术 经皮 经腔冠状动脉 血栓抽吸导管 

分 类 号：R542.22[医药卫生—心血管疾病]