ST段抬高心肌梗死急诊PCI术中血栓抽吸疗效观察

The effect of thrombus-aspiration during emergency percutaneous coronary intervention in acute ST segment elevation myocardial infarction patients

目的 观察在急性ST段抬高心肌梗死（STEMI）急诊经皮冠状动脉介入治疗术（PCI）中进行血栓抽吸术的疗效.方法 选择2007年9月至2009年12月在我中心接受急诊介入治疗的STEMI患者共177例,其中急诊介入术加血栓抽吸治疗者为血栓抽吸组（81例）,仅行急诊介入治疗患者作为标准PCI组（96例）,比较两组的基础资料、术后心肌供血和心功能指标恢复情况.结果 血栓抽吸组支架直接置入率、术后2 h ST段回落〉50%率、冠脉心肌灌注分级（TMP）和校正的TIMI记帧法（CTFC）血流均明显优于标准PCI组;发病后24 h肌酸激酶同工酶（CK-MB）值与B型尿钠肽（BNP）值显著低于标准PCI组.结论 STEMI急诊介入术中应用血栓抽吸治疗安全可靠,可增加心肌水平的血流灌注,减少坏死心肌数量,从而改善STEMI近期预后.

Objective To evaluate the effect of thrombus-aspiration during emergency percutaneous coronary intervention（PCI） in patients with acute ST segment elevation myocardial infaretion（STEMI）. Methods The STEMI patients underwent emergent PCI from September 2007 to December 2009, 81 patients received aspiration thrombeetomy were enrolled in study group, and those 96 patients who only reeeived routine PCI were enrolled in control group.The elinical data,information after operation and the follow-up data were compared between the two groups. Results Compared with control group, thrombus aspiration group had more direct stent and faster ST segment resolution. The study group had significantly improved TMP and CTFC, lower serum CK-MB and BNP level. Conclusions Thrombus-aspiration is safe and effective, and has good immediate effects during emergency PCI with STEMI, whieh eould improve myocardium perfusion and reduce myocardial necrosis.