血栓抽吸导管在年轻急性ST段抬高型心肌梗死介入治疗中的应用研究

Application value of thrombus aspiration catheter in young patients with acute STEMI during PCI

目的:探讨年轻急性ST段抬高型心肌梗死(STEMI)患者直接经皮冠状动脉介入治疗(PCI)使用血栓抽吸导管的疗效及安全性。方法:79例年轻急性STEMI患者,根据急诊PCI是否使用血栓抽吸导管分为抽吸组(使用抽吸导管,37例)及常规治疗组(不使用抽吸导管,42例),观察两组的术后冠脉血流TIMI分级、心绞痛症状、心功能状况、主要不良心血管事件(MACE)等指标的差异。结果:与常规治疗组比较,抽吸组在术后TIMI血流分级[(2.33±0.48)级比(3.00±0.00)级]、2hST段50%回落率(45.24%比70.27%)、1周时的LVEF值[(47.21±9.28)%比(52.16±7.87)%]显著上升;心绞痛症状(50.00%比27.03%)、随访中心功能分级[(1.52±0.71)级比(1.22±0.42)级]显著减少或降低(P<0.05或P<0.01)。MACE事件两组间比较差异无统计学意义(P均>0.05)。结论:年轻急性ST段抬高型心肌梗死患者PCI中使用血栓抽吸导管有助于改善冠脉血流,减少心绞痛症状,改善心功能,而且安全。

Objective：To explore the therapeutic effect and safety of thrombus aspiration catheter in young patients with acute ST-segment elevation myocardial infarction （STEMI） during primary percutaneous coronary intervention （PCI） .Methods ：According to using thrombus aspiration catheter during emergency PCI or not ,a total of 79 young patients with acute STEMI were divided into aspiration group （n= 37 ,received thrombus aspiration ） and routine treatment group （n=42 ,didn＇t receive aspiration catheter ） .Coronary TIMI flow ,angina pectoris symptoms ,cardi-ac function and major adverse cardiovascular events （MACE） etc .after PCI were observed and compared between two groups .Results：Compared with routine treatment group after treatment ,there were significant rise in TIMI flow [ （2.33 ± 0.48） grade vs .（3.00 ± 0.00） grade] ,2h ST segment regression 〉50% rate （45.24% vs .70.27% ） and left ventricular ejection fraction on the first week [ （47.21 ± 9.28）% vs .（52.16 ± 7.87）% ];significant reduction in angina pectoris symptom （50.00% vs .27.03% ） ,and NYHA cardiac function during follow-up [ （1.52 ± 0.71） class vs .（1.22 ± 0.42） class] in aspiration group , P〈0.05 or 〈0.01. There was no significant difference in incidence of MACE between two groups , P〉0.05 all .Conclusion：Application of thrombus aspiration catheter could improve coronary blood flow ,reduce symptoms of angina pectoris and improve cardiac function during primary PCI in young patients with acute STEMI ,and it＇s safe .