血栓抽吸在老年急性右冠脉闭塞心肌梗死介入治疗中的应用  

Application of thrombus aspiration on elderly acute right coronary occlusion,myocardial infarction in interventional therapy

作　　者：杨玲[1] 黄景文[1] 罗韶金[1] 薛世荣[1] 杨泽福[1] 邹军[1] 

机构地区：[1]南方医科大学附属南海人民医院心内科,广东佛山528200

出　　处：《广州医科大学学报》2015年第3期83-86,共4页Academic Journal of Guangzhou Medical University

摘　　要：目的：评价血栓抽吸在急性右冠脉闭塞心肌梗死介入治疗中的临床效果和安全性。方法：将2010年1月至2014年12月南方医科大学附属南海人民医院收治的108例老年右冠脉单支近中段闭影次全闭塞患者随机分为两组：对照组（52例）予冠脉内注射替罗非班后直接置入支架,观察组（56例）予冠脉内注射替罗非班＋血栓抽吸后置入支架。比较两组治疗后即刻TIMl血流、TMP、危险心肌抢救指数、术后30 d左室射血分数、30 d内主要心血管事件发生率等指标。结果：与对照组比较,观察组术后TIMl血流0~1级发生率低,TIMl血流3级和TMP 3级比例较高,危险心肌抢救指数及术后30 d左室射血分数提高,术后30 d内主要心血管事件发生率低（均P〈0.05）。结论：老年急性右冠闭塞心肌梗死介入治疗中应用支架联合血栓抽吸是安全、有效的方法。Objective： To evaluate the clinical effect and safety of thrombus aspiration on acute right coronary occlusion,myocardial infarction in interventional therapy. Methods： A total of 108 elderly patients with total occlusion at proximal-middle segment of single right coronary artery,who were hospitalized in Nanhai Municipal People＇s Hospital Affiliated to Southern Medical University between January 2010 and December 2014,were randomly divided into two groups： the control group（ n = 52） was given Tirofiban by intracoronary injection and underwent the placement of coronary stent directly; the study group（ n = 56） was given Tirofiban by intracoronary injection ＋ thrombus aspiration,and underwent the placement of coronary stent. The immediate TIMl blood flow after percutaneous coronary intervention,TMP,risk index of myocardial salvage,left ventricular ejection fraction（ LVEF） at 30 d after the operation,incidence of major adverse cardiovascular events（ MACE） at 30 d after the operation between the two groups were compared. Results： Compared with the control group,low incidence of postoperative TIMl blood flow（ level 0 - 1）,high ratio of level 3 TIMl blood flow and level 3 TMP,increased risk index of myocardial salvage and LVEF at 30 d after the operation,low incidence of MACE at 30 d after the operation were found in the study group（ P〈0.05）. Conclusion： The application of thrombus aspiration on elderly acute right coronary occlusion,myocardial infarction in interventional therapy is a safe and effective method.

关 键 词：血栓抽吸 急性右冠脉闭塞 经皮冠脉介入治疗 老年 

分 类 号：R542.2[医药卫生—心血管疾病]