血栓抽吸对STEMI患者直接介入治疗预后的影响

目的评价血栓抽吸治疗对急性ST段抬高型心肌梗死患者直接介入治疗预后的影响。方法直接行急诊PCI治疗的急性ST段抬高型心肌梗死患者198例。根据是否行血栓抽吸分为血栓抽吸组（62例）及常规介入组（136例），比较两组患者血运重建情况及临床效果。结果血栓抽吸组患者TIMI血流分级高于常规介入组，其发生慢血流／无复流的比例更低；血栓抽吸组患者较常规介入组患者使用球囊及植入的支架数量更少；血栓抽吸组患者PCI术后2hsT段回落〉50％的比例明显高于常规介入组，术后1周左心室射血分数较常规介入组明显改善；主要不良心血管事件发生率两组差异无统计学意义。结论血栓抽吸治疗能够改善STEMI患者TIMI血流，减少球囊使用及支架植入，改善ST段回落及左心室功能。

Objective To explore the effects of thrombus aspiration on acute ST-segment elevation myocardial infarction （ STEMI ） during primary percutaneous coronary intervention （ PCI ） . Methods One hundred and ninety eight patients with STEMI underwent primary PCI were studied. According to whether or not the treatment of the thrombus aspiration, the patients were divided into two groups, sixty two patients treated with thrombus aspiration before stent implantated, and one hundred of thirty six patients treated with primary PCI alone. Myocardial reperfusion and clinical prognosis were compared. Results The blood flow grade of infract relate artery in patients with thrombus aspiration was higher than patients with primary PCI alone. The incidence rate of slow flow/no-reflow was lower in patients with thrombus aspiration. The number of used balloon and implanted stents were lower in patients with thrombus aspiration as compared to the patients with primary PCI alone. The percentage of patients with ST-segment resolution〉50% at 2h after operation and the left ventricular ejection on the 7th day after operation were higher in patients with thrombus aspiration than that in patients with primary PCI alone. There was on significant difference between two groups in the major adverse cardiac events after operation. Conclusion The thrombus aspiration treatment can improve TIMI blood flow, reduce the use of balloon and stentt implantation in STEMI patients, and improve the ST- segment resolution and left ventricular function.