不同血栓负荷急性ST段抬高型心肌梗死患者的临床特点及介入治疗分析  

Clinical characteristics and percutaneous coronary intervention treatment in ST-segment elevation myocardial infarction patients with different thrombus burden

作　　者：田文杰[1] 李刚[1] 李其勇[1] 陈勇[1] 罗鹏[1] 李进嵩[1] 陶剑虹[1] TIAN Wen-fie LI Gang LI Qi-yong CHEN Yong LUO Peng LI Jing-song TAO Jian-hong(Department of Cardiology ,Sichuan Academy of Medical Sciences ＆ Sichuan Provincial People＇s Hospital,Chengdu 610072, China)

机构地区：[1]四川省医学科学院.四川省人民医院心内科,四川成都610072

出　　处：《实用医院临床杂志》2017年第2期52-54,共3页Practical Journal of Clinical Medicine

摘　　要：目的比较不同血栓负荷急性ST段抬高型心肌梗死(STEMI)患者的临床特点和直接经皮冠状动脉介入治疗(PCI)相关指标差异,对STEMI患者直接PCI治疗经验进行总结分析。方法回顾性分析接受直接PCI治疗的STEMI患者182例,按照血栓负荷状态分为高血栓负荷组117例与低血栓负荷组65例,比较两组患者临床特征、介入治疗相关指标,以及平均住院日、住院期间死亡率等临床结果差异。结果与低血栓负荷组患者比较,高血栓负荷组患者术中无复流或慢血流发生率更高、用于处理无复流或慢血流的药物用量更多,住院时间更长(P<0.05)。两组住院期间死亡率、再灌注心律失常发生率、术后TIMI3级血流比率比较,差异无统计学意义(P>0.05)。结论在对STEMI患者直接PCI治疗过程中,需要警惕高血栓负荷患者发生无复流或慢血流的风险,血栓抽吸、抗栓、扩冠等综合措施的合理运用,有助于高血栓负荷STEMI患者取得良好的临床效果。Objective To compare the differences in clinical characteristics of patients with ST-segment elevation myocardial infarction （STEMI） with different thrombus burden .In addition,to evaluate the relative indexes of percutaneous coronary intervention （PCI） treatment in these patients in order to summarize the PCI experiences .Methods A retrospective analysis of 182 patients with STEMI undergoing PCI treatment was performed .The patients were divided into high thrombus burden group （ n =117 ） and low-thrombus burden group （n =65）.The clinical characteristics,PCI index,average hospital stay time and in-hospital mortality were com-pared between the two groups .Results Compared with the low thrombus burden group ,the high thrombus burden group was associated with higher incidence of no-flow or slow-flow,and more usage of the medicine for the treatment of no-flow or slow-flow as well as longer in-hospital stay time （ P 〈0.05 ） .There were no differences in in-hospital mortality , incidence of reperfusion arrhythmia and TIMI-3 grade flow between the two groups （ P 〉0.05 ） .Conclusion STEMI patients with high thrombus burden are associated with higher risk of no-flow or slow-flow during PCI .Comprehensive treatment strategies including thrombus aspiration ,intra-coronary injection of an-ti-thrombus medicine and vasodilator during PCI may help to achieve good clinical effect .

关 键 词：急性心肌梗死 经皮冠脉介入治疗 血栓 

分 类 号：R541.4[医药卫生—心血管疾病]