血栓抽吸导管在急性心肌梗死患者经皮冠状动脉介入治疗中的应用

Clinical application of thrombus suction catheter in patients with acute myocardial infarction

目的评价急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)中应用Diver CE血栓抽吸导管的可靠性、实用性与安全性。方法选择我院2006年7月至2007年7月接受直接PCI的AMI患者64例,分成血栓抽吸后经皮冠状动脉介入治疗组(PT+PCI)与单纯PCI组,比较两组间TIMI血流、心肌灌注分级(TMP)(2.65±0.54)级、2 h ST段回落率56.07%±9.20%、左室射血分数(LVEF)及血管重建率。结果PT+PCI组的TIMI血流(2.54±0.18)级、TMP(2.65±0.54)级、2 h ST段回落率89.73%±9.43%、LVEF值56.07%±9.20%及血管重建率0%,明显优于单纯PCI组的TIMI血流(2.01±0.28)级、TMP(1.52±0.47)级、2 hST段回落率56.41%±12.59%、LVEF值51.11%±8.97%及血管重建率3.33%(P<0.05)。结论PCI中应用Diver CE血栓抽吸装置能明显减少冠状动脉血栓及远端栓塞,有效地改善心肌灌注,减少无复流发生,使用安全,效果明显。

Objective To evaluate the reliability, practicality and safety of the application of thrombus suction catheter during percutaneous coronary intervention （PCI） in patients with acute myocardial infarction （AMI）. Methods Sixty four AMI patients receiving direct PCI since July 2006 to July 2007 in our hospital were divided into two groups： post thrombus suction plus PCI group （ PT ＋ PCI group） and only PCI group （ PCI group）. TIMI 3-grade blood flow, myocardial blush grade （ MBG）, ST segment fallback rate in 2 hours, left ventral ejection fraction （ LVEF % ） and vascular rebuilding rate were compared. Results TIMI 3 flow （2.54 ± 0. 18 vs. 2.01 ±0. 28 ）, myocardial perfusion grade （TMP, 2. 65 ± 0. 54 vs. 1.52 ±0. 47）, ST segment fallback rate in 2 hours （89.73%±9. 43% vs. 56. 41%± 12.59% ）, LVEF value （56. 07% ±9. 20% vs. 51.11% ±8. 97% ） and vascular rebuilding rate （0% vs. 3.33% ） were all significantly higher in the PT ＋ PCI group than in the PCI group （ P 〈 0. 05 ）. Conclusion The application of Diver CE thrombus suction catheter in PCI can reduce coronary artery thrombus and distal thrombus, reduce no-reflow rate, and improve myocardial perfusion safely and effectively.