血栓抽吸对急性ST段抬高心肌梗死患者的疗效  

Therapeutic effect of thrombus suction in patients with acute ST-segment elevation myocardial infarction

作　　者：卓杨[1] 殷兆芳[1] 张亮[1] 范虞琪[1] 范例[1] 许左隽[1] 王长谦[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院心血管科,上海市200011

出　　处：《心血管康复医学杂志》2014年第4期420-424,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：上海市浦东新区卫生局卫生科技发展专项基金(PW2010D-9)~~

摘　　要：目的:探讨急性ST段抬高心肌梗死(STEMI)患者行急诊冠脉介入治疗(PCI)中使用血栓抽吸的临床疗效及对预后的影响。方法:STEMI患者105例,其中应用血栓抽吸+PCI治疗34例(血栓抽吸+PCI组),接受常规PCI治疗71例(常规PCI组),比较两组患者术后血流恢复及心功能指标的变化以及术后1年内主要不良心血管事件(MACE)及再入院情况。结果:与常规PCI治疗组相比,血栓抽吸+PCI组血流恢复后的肌酸激酶同工酶[CK-MB,(236.62±133.00)ng/ml比(186.47±69.20)ng/ml]、肌酸激酶(CK)[(2833.39±198.70)ng/ml比(2129.59±199.40)ng/ml]峰值及CK-MB[(12.38±6.70)h比(9.65±3.90)h],CK[(12.80±8.10)h比(9.68±3.50)h]峰值时间均显著降低(P均<0.05);随访1年MACE事件发生率(19.7%比8.8%)及再入院率(66.2%比50.0%)有下降趋势,但无统计学意义(P>0.05)。两组血流恢复与心功能的差异无统计学意义(P>0.05)。结论:急诊PCI术中血栓抽吸有助于减轻病情,使酶学水平显著下降,可能还改善预后。Objective：To explore therapeutic effect and prognosis of thrombus suction in patients with acute ST seg-ment elevation myocardial infarction （STEMI）during percutaneous coronary intervention （PCI）.Methods：A total of 105 STEMI patients were enrolled and divided into thrombus suction ＋ PCI group （n=34,received thrombus suction ＋ PCI therapy）and routine PCI group （n=71,received routine PCI treatment）.Postoperative TIMI flow, cardiac function during hospitalization,incidence of major adverse cardiovascular events （MACE）and rehospitaliza-tion within one-year follow-up after PCI were compared between two groups.Results：Compared with routine PCI group,there were significant reductions in peak values of creatine kinase isoenzyme [CK-MB,（236.62± 133.00） ng/ml vs.（186.47±69.20）ng/ml]and creatine kinase [CK,（2833.39± 198.70）ng/ml vs.（2129.59± 199.40） ng/ml],peak time of CK-MB [（12.38±6.70）h vs.（9.65±3.90）h]and CK [（12.80±8.10）h vs.（9.68± 3.50）h]after blood flow recovery,P 〈 0.05 all in thrombus suction ＋ PCI group;there were downtrend of MACE （19.7% vs.8.8%）and rehospitalization rate （66.2% vs.50.0%）in thrombus suction ＋ PCI group,but no significant difference between routine PCI group and thrombus suction ＋ PCI group during one-year follow-up,P 〉0.05. Conclusion：Thrombus suction is help for improving patients condition,reducing enzymology level may be effect improving prognosis.

关 键 词：心肌梗塞 血栓形成 血管成形术 经腔 经皮冠状动脉 

分 类 号：R542.22[医药卫生—心血管疾病]