介入治疗对急性心肌梗死心肌灌注呈色影响的研究进展

Research advances of the effects of interventional therapy on myocardial blush grade of acute myocardial infarction

目前,经皮冠状动脉介入（percutaneous coronary intervention,PCI）治疗已成为急性心肌梗死（acute myocardial infarction,AMI）最主要的血管开通手段.然而梗死相关动脉开通后心肌灌注程度才是心肌存活的最主要因素,因此准确评价心肌灌注状况对患者预后有重要意义.当前,临床用于评价心肌灌注状况的方法较多,例如TIMI血流分级法、心肌灌注呈色（myocardial blush grade,MBG）分级法、正电子放射断层扫描（PET）、心肌声学造影（MCE）和99mTc-MIBI心肌灌注断层显像（SPECT）等方法.其中MBG分级法具有客观、简单、经济、重复性好等特性,已广泛用于临床,尤其随着介入技术的发展如支架置入技术、血栓抽吸技术及冠状动脉内注入血小板GP IIb/IIIa受体拮抗剂等,这些技术都提高了心肌灌注MBG程度,现就近几年来这方面的研究进展做一综述.

At present, percutaneous coronary intervention （PCI） therapy has been a main recanalizition way for the infarct -related artery in the patients with acute myocardial infarction. However, the major factor of survivable myocardium depends on the reperfusion grades after the infarct - related artery opening. Thus, a accurately appraisal way used to evaluate myocardial reperfusion grades is significant for the patients in the prognosis. Nowadays, there are many methods we can take, such as thrombolysis in myocardial infarction （ TIMI ）, myocardial blush grade （ MBG ）, single - photon emission computed temography （SPECT）, positive emission tomography （PET）, myocardial contrast echocardiography （MCE）. Among them, the MBG has been widely used in clinical practice because of its actual, simple, economic, reusable features. Especially, the development of interventional therapy, such as stent implanting, thrombus aspiration and GP Ⅱb/Ⅲa receptor inhibitor used in coronary, greatly improves the MBG. We will sum up the advances about it in recent years.