血栓抽吸在急性STEMI患者急诊PCI中的应用被引量：2

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摘要目的评估急性ST段抬高心肌梗死(STEMI)患者行急诊经皮冠状动脉介入治疗(PCI)中应用血栓抽吸对心肌组织灌注及临床预后的影响。方法选择我院2008年1月至2010年6月行急诊PCI的STEMI患者196例,术中行血栓抽吸94例为血栓抽吸组,传统PCI组102例,比较两组TIMI血流、cTFC帧数、术后2hST段50%回落率及术后1周LVEF等。结果血栓抽吸组与传统PCI组比较:无复流或慢血流发生率为6.4%vs17.6%,术后即刻TIMI血流3级为93.6%vs82.4%,cTFC帧数为(28.7±7.6)vs(41.5±6.4)、ST段回落率为78.72%vs64.71%,LVEF为(54.65±7.52)%vs(46.56±6.12)%,血栓抽吸组均优于传统PCI组(P<0.05)。结论 STEMI患者急诊PCI术中应用血栓抽吸可降低无复流发生率,改善心肌组织灌注及左室收缩功能。

作者王玉平马洪俊桂正光赵树武

机构地区天津市大港油田总医院心血管一科

出处《海南医学》 CAS 2012年第19期29-30,共2页 Hainan Medical Journal

关键词血栓抽吸急性ST段抬高心肌梗死冠状动脉介入治疗

分类号 R542.22 [医药卫生—心血管疾病]

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1Kushner K, Hand M,Smith SC Jr, et al. 2009 focused updates:ACC/AHA guidelines for the management of patients widi ST-elevationmyocardial infarction (updating) and ACC/AHA/SCAI guidelineson percutaneous coronary intervention (updating the 2005 guidelineand 2007 focused update) [J]. J Am Coll Cardiol, 2009,54(23):2205-2241.
2Reakalla SH,Kloner RA. No refolw phenon enoa [J]. Circulation,2002, 105(5): 656-662.
3Brosh D, Assali AR, Mager A, et al. Effect of no-reflow during pri-mary percutaneous coronary intervention for acute myocardial in-farction ofl six-month mortality [J]. Am J Cardiol, 2007,99(4):442-445.
4高润霖.急性心肌梗死诊断和治疗指南[J].中国循环杂志,2001,16(6):407-422. 被引量：417
5马长生,董建增,冠心病介人治疔技术与策略[M].2版.北京:人民卫生出版社,2005: 690.
6Ui S, Chino M, Isshiki T. Rates of primary percutaneous coronaryintervention workdwide [J]. Circ J, 2005, 69(1): 95-100.
7罗江宾,王天松,邓明尧,冯旭霞.血栓抽吸联合替罗非班在急性ST段抬高型心肌梗死急诊冠脉介入治疗中的应用[J].海南医学,2011,22(20):6-8. 被引量：14

二级参考文献11

1董鹏,王斌,李镝,靳维华,曲涛.替罗非班在急诊经皮冠状动脉介入术中抗血栓作用的疗效及安全性[J].实用心脑肺血管病杂志,2007,15(2):102-103. 被引量：16
2Fuster V, Badimon L, Badimon JJ, et al. The pathogenesis of coronary artery disease and the acute coronary syndromes[J]. N Engl J Med, 1992, 326: 242-250, 310-318.
3Sianos G, Papafaklis MI, Daemen J, et al. Angiographic stent thrombosis after routine use of drug-eluting stents in ST-segment elevation myocardial infarction: the importance of thrombus burden [J]. J Am Coll Cardiol, 2007, 50: 573-583.
4Prasad A, Stone GW, Aymong E, et al. Impact of ST-segment resolution after primary angioplasty on outcomes after myocardial infarction in elderly patients: an analysis from the CADILLAC trial [J]. Am Heart J, 2004, 147: 669-675.
5Ito H, Maruyama A, Iwakun K, et al. Clinical implications of the ‘no reflow’ phenomenon. A predictor of complications and left ventricular remodeling in reperfused anterior wall myocardial infarction [J]. Circulation, 1996, 93: 223-228.
6Resnic FS, Wainstein M, Lee MK, et al. No-reflow is an independent predictor of death and myocardial infarction after percutaneous coronary intervention[J]. Am Heart J, 2003, 145: 42-46.
7Skyschally A, Leineweber K, Gres P, et al. Coronary microembolization[J]. Basic Res Cardiol, 2006, 101: 373-382.
8Yip HK, Wu CJ, Chang HW, et al. Impact of tirofiban on angiographic morphologic features of high-burden thrombus formation during direct percutaneous coronary intervention and short-term outcomes[J]. Chest, 2003, 124: 962-968.
9Yang TY, Chang ST, Chung CM, et al. Restoration of normal coronary flow with tirofiban by intracoronary administration for no-reflow phenomenon after stent deployment[.J]. Int Heart J, 2005, 46:139-145.
10Stone GW, Webb J, Cox DA, et al. Distal microcirculatory protection during percutaneous coronary intervention in acute ST-segment elevation myocardial infarction. A randomized controlled trial [J]. JAMA, 2005, 293: 1063-1072.