血栓抽吸术对急性STEMI患者QTc间期和预后的影响  

Impact of thrombus aspiration on QTc interval and clinical prognosis in patients with ST segment elevation myocardial infarction

作　　者：杨曙艳[1] 李牧蔚[2] 刘伟利[2] 王宪沛[2] 张优[2,3] 齐大屯[2] 胡大一 高传玉[2] 

机构地区：[1]河南省胸科医院心电图室,河南郑州450003 [2]郑州大学人民医院心血管内科,河南郑州450003 [3]河南省心血管流行病学中心,河南郑州450003

出　　处：《河南医学研究》2017年第12期2116-2119,共4页Henan Medical Research

摘　　要：目的探讨血栓抽吸术对ST段抬高型心肌梗死(STEMI)患者QTc间期和预后的影响。方法选取86例采用EXPORT导管血栓抽吸术治疗的前壁STEMI患者作为血栓抽吸组,并选择同期连续没有使用EXPORT导管血栓抽吸术的80例前壁STEMI患者作为非血栓抽吸组。对比分析两组STEMI患者TIMI血流分级,校正TIMI帧数,ST段抬高回落百分比,心电图QTc间期变化,血浆肌钙蛋白I峰值时间,左室舒张末内径(LVEDd),左室射血分数(LVEF)及临床预后。结果与非血栓抽吸组比较,血栓抽吸组QTc间期和肌钙蛋白峰值时间明显缩短,峰值明显下降(P<0.05);PCI结束时TIMI血流明显改善(P<0.05);住院期间恶性心律失常略有减少(P<0.05)。结论血栓抽吸术可缩短STEMI患者QTc间期,但对住院期间和PCI术后6个月的心血管预后无明显改善。Objective To explore the impact of thrombus aspiration on QTc interval and progress in patients with ST segment elevation myocardial infarction （STEMI）. Methods 86 patients with STEMI treated with thrombus aspiration using EXPORT catheter were selected as thrombus aspiration group, and 80 patients with STEMI not treated with thrombus aspiration were selected as non - thrombus aspiration group. TIMI flow grade, corrected TIMI frame count, ST reduction percent at end of PCI procedure, QTc interval, peak time of plasm TnI, LVEDd, LVEF and clinical prognosis were compared between two groups. Results Compared with non- thmmbus aspiration group, the QTc interval and peak time of plasm TnI were shorter, and the peak value was smaller, TIMI flow in the end of PCI was well improved with less adverse cardiac events in thrombus aspiration group （P 〈 0. 05）. Conclusion Thrombus aspiration can shorten QTc interval in patients with STEMI, but can not improve cardiovascular prognosis during hospital stay and 6 months after PCI.

关 键 词：ST段抬高心肌梗死 血栓抽吸 QTC间期 预后 

分 类 号：R542.22[医药卫生—心血管疾病]