急性心肌梗死患者血栓抽吸对支架晚期贴壁不良的影响

The effects the correlation between acute myocardial infarction with thrombus suction on late stent malapposition

目的研究急诊心肌梗死患者血栓抽吸与支架晚期贴壁不良(LSM)发生率的相关性。方法实验共纳入急性心肌梗死患者125例,分为实验组与对照组,实验组55例,对照组70例。入组前签署知情同意书。实验组在经皮支架植入(PCI)前行血栓抽吸,对照组直接PCI。两组患者PCI后即刻行冠脉内血管超声(IVUS),并在支架植入后6～9个月复查IVUS,记录2次检查中的血管外弹力膜面积、中膜面积、内膜横截面积以及血管管腔面积,观察指标为LSM发生例数、血管面积变化值。结果①实验组有4例患者发生LSM;对照组为15例(P<0.05);②实验组血管外弹力膜增加面积、中膜增加面积、管腔减少面积及内膜增生横截面积等指标均小于对照组(P<0.05)。结论急诊心肌梗死患者进行血栓抽吸能够降低支架晚期贴壁不良的发生率。

Objective To study the correlation between thrombus aspiration and late stent attachment defect in patients with acute myocardial infarction.Methods A total of 125 cases with acute myocardial infarction were divided into the experimental group and the control group.The experimental group was selected 55 patients;the control group was 70 cases.Informed consent were signed before entering the group.The experimental group received thrombus aspiration before percutaneous stent implantation (PCI),while the control group received direct PCI.Coronary artery ultrasound (IVUS) was performed immediately after PCI in the two groups,and IVUS was rechecked for 6-9 months after PCI.The area of extravascular elastic membrane,middle membrane area,intersectional area of intima and vascular lumen area were recorded.The number of cases of LSM and the change of blood vessel area were observed.Results ①There were 4 cases of LSM in the experimental group and 15 cases in the control group (P< 0.05);②The increase area of the extravascular elastic membrane in the experimental group,the increase of the area of the middle model,the area of the lumen reduction and the cross section area of the intima hyperplasia were less than those of the control group (P< 0.05).Conclusion Thrombus aspiration in patients with acute myocardial infarction can reduce the incidence of late stent malformation.