Diver CE抽吸导管在急性ST段抬高型心肌梗死中价值

Value of Diver CE aspiration catheter to the evaluation of acute ST-segment elevation myocardial infarction

目的 评价急性心肌梗死后不同时间段应用Diver CE抽吸导管的疗效。方法 急性ST段抬高型心肌梗死（STsegment elevation acute myocardial infarction,STEMI）患者220例,均在冠状动脉造影后行血栓抽吸,植入支架。根据心肌缺血症状发生至抽吸导管使用时间分为观察组（〈3h）和对照组（≥3~12h）各110例,观察并比较2组术后心肌梗死溶栓治疗（thrombolysis in myocardial infarction,TIMI）分级、校正TIMI帧数（corrected TIMI frame count,cTFC）、术后2hST段回落率（ST-segment recovery,STR）等再灌注指标。结果 2组年龄,性别比例,合并高血压、2型糖尿病、高脂血症情况、吸烟史和梗死相关血管部位比较差异均无统计学意义（P〉0.05）;观察组术后即刻TIMI 3级血流比率（88.2%）、STR≥50%比率（82.7%）高于对照组（64.5%、68.1%）,cTFC[（25.7±6.1）帧]低于对照组[（40.1±11.2）帧],2组比较差异均有统计学意义（P〈0.05）。结论 发生急性心肌梗死后3h内应用Diver CE抽吸导管可获更佳疗效。

Objective To assess the effect of Diver CE aspiration catheter in different time periods after acute myocardial infarction. Methods A total of 220 patients with ST-segment elevation acute myocardial infarction （STEMI） received thrombus aspiration by Diver CE aspiration catheter and stent implantation after coronary angiography, and were divided into observation group （〈3 h） and control group （≥3 to 12 h） based on the starting time of using aspiration catheter after myocardial ischemia, with 110 patients in each group. Thrombolysis in myocardial infarction （TIMI） flow grade, corrected TIMI frame count （cTFC） , and ST segment recovery （STR） 2 hours after operation were observed and compared between two groups. Results There were no significant differences in the age, sex, hypertension, type 2 diabetes meUitus, hyperlipidemia, smoking history and infarct-related artery site between two groups （P〉0.05）. The proportions of TIMI 3 flow grade and STR≥50% were significantly higher in observation group （88.2%, 82.7%） than those in control group （64.5%, 68. 1%） （P〈0.05）, while the value of cTFC was lower than that in control group （25.7±6.1 vs 40. 1± 11. 2） （P〈0.05）. Conclusion A better effect can be obtained by using Diver CE aspiration catheter within three hours after acute myocardial infarction.