血栓抽吸联合经皮冠状动脉介入治疗与单纯经皮冠状动脉介入治疗对心肌再灌注影响的比较研究

Comparison of thrombus aspiration combined with percutaneous coronary intervention and percutaneous coronary intervention alone on myocardial reperfusion

目的比较血栓抽吸联合经皮冠状动脉介入治疗(PCI)与单纯PCI对心肌再灌注的影响。方法选取2012年1月至2014年8月首都医科大学附属北京潞河医院收治的急性ST段抬高心肌梗死患者215例,根据术前是否进行血栓抽吸分为血栓抽吸联合PCI组(105例)和单纯PCI组(110例),收集并比较两组患者的一般资料、PCI术中情况和疗效。结果与单纯PCI组相比,血栓抽吸联合PCI组患者TIMI血流Ⅲ级、ST段回落≥1/2、左心室射血分数≥50%发生率较高,心肌染色分级较高,无复流、再发心肌梗死发生率较低(P<0.05)。结论血栓抽吸联合PCI能够改善患者的血运和心肌再灌注,改善患者的心肌功能,可广泛应用于临床。

Objective To compare thrombus aspiration combined with percutaneous coronary intervention （PCI） and PCI alone on myocardial reperfusion. Methods 215 patients with acute ST segment elevation myocardial infarction from January 2012 to August 2014 in our hospital were included and divided into thrombus aspiration combined with PCI group （n = 105 ） and PCI group （n = 110） according to whether thrombus aspiration was performed before intervention. Results Compared to sole PCI group, patients in the thrombus aspiration combined with PCI group had higher rate of TIMI grade 3 （90. 5% vs. 99. 1% ）, ST segment≥ 1/2 resolution （86. 7% vs. 72. 7% ） and left ventrieular ejection fraction ≥50% （58. 1% vs. 41.8% ）, but less oceurrance rates in no reflow （4. 8% vs. 15.5% ） and recurrent myocardial infarction （ 1.0% vs. 6.4% ） （ all P 〈 0. 05 ） . Conclusions Thrombus aspiration combined with PCI can improve revascularization, myocardial reperfusion and cardiac function of patients.