不同时机行PCI联合选择性血栓抽吸术治疗急性ST段抬高型心肌梗死的效果比较

Effects of PCI combined with selective thrombus aspiration at different timings in the treatment of acute ST-segment elevation myocardial infarction

目的比较分析发病至急诊12 h内、12~48 h对ST段抬高型心肌梗死(STEMI)患者行PCI联合选择性血栓抽吸术治疗的效果。方法抽取濮阳市中医医院2018年2月至2020年3月收治的87例STEMI患者为研究对象,按照发病至急诊间隔时间分组,其中A组(发病至急诊间隔时间为12 h以内)41例、B组(发病至急诊间隔时间为12~48 h)46例。A组、B组就诊后均行经皮冠状动脉介入术(PCI)联合选择性血栓抽吸术治疗。记录两组心功能、近期预后及心肌梗死溶栓治疗实验(TIMI)血流分级情况。结果治疗后,A组、B组TIMI血流分级3级所占比例均较治疗前提高(P<0.05),组间比较差异未见统计学意义(P>0.05)。A组、B组随访期间各项心脏不良事件发生情况比较差异未见统计学意义(P>0.05)。结论发病至急诊12 h内、12~48 h针对STEMI患者行PCI联合选择性血栓抽吸术治疗效果均较优,临床医生应在今后实际工作中结合患者实际情况决定PCI联合选择性血栓抽吸术的治疗时机。

Objective To compare the therapeutic effect of PCI combined with selective thrombus aspiration on patients with acute ST-segment elevation myocardial infarction(STEMI)within 12 h and 12-48 h from onset to admission of emergency medicine.Methods A total of 87 STEMI patients admitted to Puyang Hospital of Traditional Chinese Medicine from February 2018 to March 2020 were selected as the subjects of this study.They were divided into groups according to the intervals from onset to admission of emergency medicine.Among them,41 cases were in group A(the interval between onset to admission of emergency medicine within 12 h),46 cases in group B(the interval between onset to admission of emergency medicine with in 12-48 h).Both group A and group B were treated by PCI combined with selective thrombus aspiration after treatment.And cardiac function,recent prognosis,and the thrombolysis in myocardial infarction(TIMI)classifications of the two groups were recorded.Results After treatment,the proportions of TIMI blood flow grade 3 in group A and group B were significantly higher than those before treatment(P<0.05).There was no statistically significant difference in proportions of TIMI blood flow grade 3 between the two groups after treatment(P>0.05).There was no significant difference in occurrence of any cardiac adverse events between group A and group B during follow-up(P>0.05).Conclusions The effect of PCI combined with selective thrombus aspiration on STEMI within 12 h,and 12-48 h from onset to admission of emergency medicine is better.Clinicians should determine the treatment timing of PCI combined with selective thrombus aspiration based on the actual conditions of patients in the future.