血栓抽吸在高血栓负荷急性前壁心肌梗死患者急诊介入中的应用

Application of thrombus aspiration in primary percutaneous coronary intervention in patients with acute anterior myocardial infarction with high thrombus burden

目的:探讨血栓抽吸在高血栓负荷急性前壁心肌梗死患者急诊经皮冠状动脉介入(PCI)治疗中的有效及安全性。方法:选取2020年1月至2021年9月,在首都医科大学附属北京安贞医院行急诊PCI的高血栓负荷急性前壁心肌梗死患者共151例。根据是否行血栓抽吸术分为血栓抽吸+PCI组(n=84)和单纯PCI组(n=67)。比较两组患者术后即刻的TIMI血流分级、心肌呈色(MBG)分级以及随访6个月内的心血管不良事件和卒中的发生率。结果:两组患者在高血压、吸烟、糖尿病、GP Ⅱb/Ⅲa受体拮抗剂使用率、住院至球囊扩张时间(D-to-B)等基本临床资料方面,差异无统计学意义(P>0.05)。两组患者术后TIMI血流分级及MBG分级差异无统计学意义(P>0.05),随访6个月内心血管不良事件和脑卒中的发生率也差异无统计学意义(P>0.05)。结论:血栓抽吸并未改善高血栓负荷前壁心肌梗死的患者的预后及心肌的再灌注水平,也未增加卒中的发生风险。

Objective:This study aimed to investigate the efficacy and safety of thrombus aspiration in primary percutaneous coronary intervention(PCI) in patients with acute anterior myocardial infarction with high thrombus burden.Methods:A total of 151 patients with acute anterior myocardial infarction with high thrombus burden who underwent primary PCI in Beijing Anzhen Hospital Affiliated to Capital Medical University from January 2020 to September 2021 were selected.According to whether thrombus aspiration was performed or not,they were divided into thrombus aspiration + PCI group(n=84) and PCI alone group(n=67).The TIMI blood flow classification,MBG classification,and the incidence of cardiovascular adverse events and stroke within 6 months of follow-up were compared between the two groups of patients.Results:There were no significant differences in basic clinical data such as hypertension,smoking,diabetes,GP Ⅱb/Ⅲa receptor antagonist usage rate,hospitalization to balloon dilation time(D-to-B) between the two groups(P > 0.05).There was no significant difference in postoperative TIMI blood flow classification and MBG classification between the two groups(P > 0.05),and there was no significant difference in the incidence of cardiovascular adverse events and stroke within 6 months of follow up(P > 0.05).Conclusions:Thrombus aspiration does not improve the prognosis and myocardial reperfusion level of patients with high thrombus burden in patients with anterior myocardial infarction,nor does it increase the risk of stroke.