血栓抽吸治疗在老年急性心肌梗死介入治疗中的应用  

Thrombus aspiration in intervention treatment of elderly acute myocardial infarction patients

作　　者：钟志英[1] 盛国太[2] 唐昱[2] 余茂生[2] 吴志勇[2] 

机构地区：[1]江西省南昌大学附属第四医院心内科,330006 [2]江西省人民医院心内科

出　　处：《辽宁医学杂志》2014年第6期301-303,共3页Medical Journal of Liaoning

摘　　要：目的评价血栓抽吸治疗在急性心肌梗死(AMI)老年患者经皮冠状动脉介入治疗(PCI)中的疗效。方法回顾性分析2011年1月至2012年12月在我院行PCI术的AMI老年患者80例,其中单纯直接PCI术为对照组(n=40),直接PCI术联合血栓抽吸治疗为血栓抽吸组(n=40)。评估PCI术后TIMI血流分级、慢血流或无复流、PCI术后ST段回落率、术后肌酸激酶同工酶(CK-MB)和肌钙蛋白T(TnI)从发病到达峰值时间、术后1周和6个月左室射血分数(LVEF)、住院期间和PCI术后6个月内主要心脏不良事件(MACE)发生率。结果与对照组相比,血栓抽吸组PCI术后即刻TIMI3级比例(95.0%比75.0%,P<0.05),慢血流或无复流(5.0%比75.0%,P<0.05),ST回落率(65.3±7.9比42.1±10.8,P<0.05),术后CK-MB和TnT达峰时间均有提前,但差异无显著性。1周后LVEF(50.2±8.6比49.1±9.1,P>0.05),6个月后LVEF(54.1±3.2比49.6±8.3,P<0.05)。结论在老年AMI患者PCI中应用血栓抽吸治疗是有效的,能改善心肌灌注,提高LVEF,对预后产生积极疗效。Objective To evaluate the efficiency of thrombus aspiration during percutaneous coronary intervention （PCI） in elderly patients with acute myocardial infarction （ AMI ）. Methods We reviewed 80 AMI patients whom received PCI from January 2011 to December 2012. Forty patients who received PCI and thrombus aspiration were enrolled in study group and forty patientswhich only received PCI were enrolled in control group. Thrombolysis in myocardial infarction（TIMI） flow grade, the rate of occurring no-reflow phenomenon and directly implanting stents, ST-segment resolution, peak value time of CK-MB and Tnl, left ventricle ejection fraction（LVEF） in one week and six months after PCI and major adverse cardiovascu- lar events（MACE） in hospital and 6 months after PCI were all compared between the two groups. Results Comparing with control group, the thrombus-aspiration group had a higher rate of post-procedural TIMI III blood flow（95.0% vs75.0% , P 〈 0. 05 ） and ST-segment resolution（ 65.3 ± 7.9vs42. 1 ± 10. 8, P 〈 0. 05 ）, Slow flow/no reflow rates were lower in the the thrombus-aspiration group than in the control group （5.0% vs75.0% ,P 〈 0. 05 ）. The peak time of CK-MB and TnI was ear- lier ahead the schedule in thrombus aspiration group, without significant difference between two groups. Compared with control group, LVEF of study group were improved after one week and six months（50. 2：1：8. 6）vs（49. 1 ±9. 1）, （54. 1 ±3.2） vs （49. 6± 8.3 ）. MACE was decreased in observed group compared to the control group in hospital, but there was not statis- tical significant between 2 groups. Conclusion Thrombus aspiration is applicable in elderly patients with AMI, and it re- suits in better reperfusion and higher LVEF, which may bring out a positive prognosis.

关 键 词：血栓抽吸 心肌梗死 经皮冠状动脉介入治疗 老年 

分 类 号：R542.22[医药卫生—心血管疾病]