血栓抽吸并直接PCI对老年急性STE-MI患者的治疗效果  

Therapeutic effect of thrombus suction and direct PCI for elderly patients with acute STE-MI

作　　者：王端[1] 司良毅[1] 

机构地区：[1]第三军医大学西南医院老年科,重庆400038

出　　处：《重庆医学》2016年第8期1053-1055,共3页Chongqing medicine

摘　　要：目的探讨血栓抽吸并直接经皮冠状动脉介入治疗(PCI)对老年急性ST段抬高型心肌梗死(STE-MI)患者的治疗效果。方法收集2012年9月至2014年9月该院收治的老年急性STE-MI患者124例,经患者及家属知情同意,分为两组,观察组(n=56)行血栓抽吸并直接PCI术治疗,对照组(n=68)行单纯PCI术治疗;观察两组患者术后即刻冠状动脉内溶栓后冠状动脉血流情况(TIMI),术后校正的TIMI帧数(CTFC),肌红蛋白、肌钙蛋白(cTnT)、肌酸激酶同工酶(CK-MB)水平,术后1hST抬高回落超过50%百分比,术后随访6个月。结果观察组术后1hST段抬高回落超过50%百分比明显高于对照组(P<0.05);观察组肌红蛋白、cTnT、CK-MB水平,术后校正的CTFC、术后无复流率和慢复流率均明显低于对照组(P<0.05);两组患者主要心血管不良事件(如心绞痛、心肌梗死、再次血运重建等)的发生率比较,差异无统计学意义(P>0.05);观察组患者的左心室射血分数(LVEF)>50%百分比明显高于对照组(P<0.05);且两组患者手术前、后LVEF>50%百分比比较,差异均有统计学意义(P<0.05)。结论血栓抽吸并直接PCI对老年急性STE-MI患者的临床疗效明显优于单纯直接PCI治疗。Objective To study the therapeutic effect of the thrombus suction and direct percutaneous coronary intervention（PCI）for elderly patients with acute ST segment elevation myocardial infarction（STE-MI）.Methods A total of 124 elderly patients with acute STE-MI in our hospital from September 2012 to September 2014 were collected and divided into two groups（under the agreement of patients and family members）,the experimental group（56cases）was treated with thrombus suction and direct PCI,while the control group（68cases）was only treated with PCI treatment;the postoperative immediate TIMI flow of coronary artery,postoperative corrected TIMI frame count（CTFC）,levels of myoglobin,cTnT and CK-MB,percentage of ST elevation back over 50%,postoperative 6-month follow-up situation were observed in the two groups.Results The percentage of postoperative ST segment elevation drop〉50% at postoperative 1hin the experimental group was significantly higher than that in the control group（P〈0.05）;the levels of myoglobin,cTnT and CK-MB,postoperative corrected CTFC frames and rate of no reflow in the experimental group were significantly lower than those in the control group（P〈0.05）;during postoperative 6-month follow up,there were no statistically significant differences in major adverse cardiac events（such as angina pectoris,myocardial infarction,revascularization,etc）between the two groups（P〉0.05）;the percentage of LVEF〉50%in the experimental group was significantly higher than that in the control group（P〈0.05）,moreover the percentage of LVEF〉50%in the two groups had statistical difference between before and after operation（P〈0.05）.Conclusion Clinical curative effect of thrombus suction and direct PCI for elderly patients with acute STE-MI is superior to simple direct PCI treatment.

关 键 词：血栓抽吸 经皮冠状动脉介入治疗 急性ST段抬高型心肌梗死 

分 类 号：R542.22[医药卫生—心血管疾病]