血栓抽吸治疗在急诊冠脉介入治疗中的应用

Use of thrombus extraction during primary percutaneous coronary intervention

目的:评价急性心肌梗死急诊经皮冠脉介入治疗(PCI)中应用ZEEK血栓抽吸导管对改善心肌组织再灌注及对患者临床预后的作用。方法:选择2009年7月至2010年4月符合急诊PCI介入指征的急性心肌梗死患者58例,其中使用ZEEK血栓抽吸导管18例作为血栓抽吸组,未使用ZEEK血栓抽吸导管40例作为对照组,比较两组的基线资料、造影结果和临床预后。结果:血栓抽吸组TIMI3级血流比例、ST段回落率、无复流或慢血流现象发生率及出院前EF平均值均明显优于对照组(P<0.05)。结论:在急性心肌梗死急诊PCI中应用ZEEK血栓抽吸导管安全可行,有效地清除冠脉内血栓,改善心肌组织灌注,有可能改善术后心脏功能,并且不增加血管不良事件的发生率。

Objective：To assess the effect of ZEEK aspiration thrombectomy catheter in improving myocardial reperfusion and clinical prognosis in patients with acute myocardial infarction （AMI） who underwent primary percutaneous coronary intervention （PCI）. Methods：From Jul. 2009 to Apr. 2010, a total of 58 patients with STEMI undergoing primary PCI were enrolled in this study, and ZEEK aspiration thrombectomy catheters were used in 18 cases of them. Baseline characteristics, angiographic results and clinical prognoses were compared between the two groups. Results：ST-segment resolution, TIMI3 flow, rate of distal embolization, and average left ventricular ejection fraction before hospital discharge were significantly improved in ZEEK group compared to those in the control group. Conclusion：In AMI patients treated with primary PCI, the application of ZEEK aspiration thrombectomy catheter is safe and effective, which can lower thrombosis burden, improve distal myocardium perfusion and cardiac function after the procedure, and dose not increase the incidence of blood vessel event.