血栓抽吸术对急性心肌梗死1年预后的影响  

Thrombus aspiration in acute myocardial infarction： One year follow-up result

作　　者：韩文正[1] 关韶峰[1] 施鸿毓[1] 曲新凯[1] 仇兴标[1] 陈晖[1] 方唯一[1] 侯旭敏[1] 

机构地区：[1]上海交通大学附属胸科医院心内科,上海市200030

出　　处：《中国心血管病研究》2017年第5期436-440,共5页Chinese Journal of Cardiovascular Research

摘　　要：目的 探讨血栓抽吸术对急性ST段抬高心肌梗死患者预后的影响.方法 回顾性分析2013年1月至2015年2月于上海市胸科医院就诊发病时间＜12 h的急性ST段抬高心肌梗死患者257例,所有患者均进行急诊PCI治疗.最终完成1年随访的患者中121例患者进行血栓抽吸术,136例患者进行直接PCI.随访两组患者30 d、1年的MACE事件及心功能.结果 两组患者在30 d（3.3％比5.1％,P=0.548）、1年的MACE事件（5.7％比8.8％,P=0.475）发生率上未见统计学差异.虽然即刻TIMI 3级血流比例两组同样没有差异（72.7％比69.9％,P=0.679）,但两组在NYHAⅢ～Ⅳ心衰的比例30 d随访（15％比26.3％,P=0.044）、1年随访（5.0％比12.9％,P=0.047）血栓抽吸组均显著降低.结论 血栓抽吸术对心血管主要不良事件无显著影响,但对于降低远期心衰的发作仍具有重要作用.Objective To evaluate the effect of thrombus aspiration in acute ST elevation myocardial infarction.Methods This study retrospectively analyzed 257 patients with STEMI from Jan 2013 to Feb 2015.121 patients accepted thrombus aspiration before PPCI,while 136 patients accepted conventional primary PCI.The primary outcome （target vessel revascularization,cardiac death,myocardial reinfarction） was followed 30 days and 1 year after procedure.The ratio of NYHA Ⅲ-Ⅳ was also followed 30 days and 1 year after procedure.Results The primary outcome at 30 days occurred 3.3% of 121 patients in thrombectomy group compared with 5.1% of 136 in the PCI alone（P=0.548）,while 1 year result also showed no significant difference between two groups（5.7% vs 8.8%,P=0.475）.Although TIMI grade showed no difference （72.7% vs 69.9%,P=0.679）,the ration of NYHA Ⅲ-Ⅳ at 30 days showed significant difference between two groups （15% vs 26.3%,P=0.044）.Meanwhile 1 year follow-up also showed lower ratio of NYHA Ⅲ-Ⅳ in thrombectomy group （5.0% vs 12.9%,P=0.047）.Conclusion Thrombus aspiration during PCI for STEMI dose not reduce longer-term clinical outcomes including target vessel revascularization,cardiac death,myocardial reinfarction.But thrombus aspiration might improve the clinical heart function.

关 键 词：血栓抽吸术 急性ST段抬高心肌梗死 心力衰竭 

分 类 号：R542.22[医药卫生—心血管疾病]