血栓抽吸术改善急性心肌梗死心肌再灌注的临床研究

Thrombus aspiration improves myocardial reperfusion in acute myocardial infarction

目的探讨冠状动脉内血栓抽吸并联合球囊成型及支架置入术治疗急性心肌梗死（AMI）对梗死心肌再灌注的影响。方法进行急诊PCI的AMI患者共156例，对其中78例进行冠状动脉内血栓抽吸，然后进行球囊扩张及支架置入治疗。术后造影观察冠状动脉扩张效果及梗死相关血管血流及心肌灌注、心电图STR情况。结果抽吸血栓组与同期入选未抽吸组相比，TIMI血流3级分别为89％和78％；TMP灌注3级分别为88％和45％，STR〉50％者分别为68％和50％。结论经导管进行冠状动脉内血栓抽吸是治疗急性心肌梗死简单有效的方法，并可提高经皮冠状动脉介入治疗的成功率，减少无再流等并发症的发生。

Objective To investigate whether the thrombous aspiration material can improve myocardial reperfusion compared with conventional primary percutaneous coronary intervention （PCI）. Methods 156 patients with acute myocardial infarction were divided into two groups：78 patients who underwent intervention without a thrombus aspiration device and 78 patients who were treated with thrombus aspiration catheter before PCI. TIMI flow grade, TMP grade and STR were observed. Results The flow was improved in the thrombus aspiration group compared with PCI group TIMI 3 （89% vs 78%）, TMP grade （88% vs 45%）, STR〉50%（68% vs 50%）. Conclusion This study shows that manual thrombus-aspiration in acute myocardial infarction is clinically feasible and results in better angiographic and ECG myocardial reperfusion rates compared with those achieved by standard PCI.