血栓抽吸导管对小血栓负荷急性心肌梗死患者介入治疗的影响

Effect of thrombus aspiration catheter during primary percutaneous coronary intervention on acute myocardial infarction patients with small thrombosis burden

目的探讨血栓抽吸导管对小血栓负荷的急性心肌梗死患者直接经皮冠状动脉介入治疗（PCI）后心肌组织水平灌注和临床预后的影响。方法连续入选小血栓负荷的急性心肌梗死患者83例。随机分为治疗组（36例）经冠状动脉内血栓抽吸导管抽吸后植入支架;对照组（47例）标准支架植入术。比较两组患者临床基线资料、术后冠状动脉造影结果、心电图、心功能变化及随访期间主要不良心血管事件情况。结果两组患者的基线临床资料差异均无统计学意义（P均〉0.05）。对照组患者1例术后出现慢血流,其余患者术后心肌梗死溶栓试验（TIMI）血流均达到3级;治疗组均达到TIMI血流3级,但两组相比未达到统计学差异。两组患者术后2h ST段回降程度、术后5-7d左心室射血分数及术后12个月主要不良心脏事件发生率差异均无统计学意义。结论血栓抽吸导管对小血栓负荷急性心肌梗死患者行直接PCI时未能获得更多的益处。

Objective To explore the impact of thrombus aspiration catheter on myocardial reperfusion and major adverse cardiovascular events rate in acute myocardial infarction patients with small thrombosis burden. Methods Eighty –three consecutive acute myocardial infarction patients with small thrombosis burden were randomly assigned to thrombus aspiration group（n=36） and standard stent implantation group（n=47） with random number table.Baseline clinical data,angiographic features, electrocardiogram, heart function and major adverse cardiovascular events after PCI between 2 groups were compared. compared.Results The baseline clinical data between 2 groups was similar（all P〉0.05）. One patients had slow flow in standard stent implantation group, the remaining patients with TIMI 3 flow were achieved in 2 groups. ST-segment elevation reduction at 2 hours, left ventricular ejection fraction at 5-7 days and the incidence of major adverse cardiovascular events at 12 months after PCI showed no significant differences. Conclusion Thrombus aspiration catheter during primary percutaneous coronary intervention on acute myocardial infarction patients with small thrombosis burden failed to gain more benefits.