Export抽吸导管在急性ST段抬高型心肌梗死治疗中应用价值

Value of Export thrombus aspiration catheter to the treatment of acute ST-segment elevation myocardial infarction

目的评价急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者不同时间段应用Export血栓抽吸导管治疗的疗效。方法 STEMI患者160例,冠状动脉造影后行血栓抽吸并植入支架。根据心肌缺血症状发生至血栓抽吸导管使用时间分为观察组(3~12h)和对照组(<3h)各80例。观察并比较2组术后心肌梗死溶栓治疗(thrombolysis in myocardial infarction,TIMI)3级血流率、术后胸痛缓解率、术后2hST段回落率(ST segment recovery,STR)等再灌注指标。结果 2组性别比例,年龄,梗死相关血管部位,合并高脂血症、高血压病、2型糖尿病和吸烟史比率比较差异均无统计学意义(P>0.05);观察组术后即刻TIMI 3级血流发生率(80.0%)、术后胸痛缓解率(90.0%)、STR≥70%发生率(68.8%)均高于对照组(38.8%、71.3%、45.0%),2组比较差异有统计学意义(P<0.05)。结论发生STEMI后3~12h应用Export血栓抽吸导管进行血栓抽吸可获最佳疗效。

Objective To explore the efficacy of Export thrombus aspiration catheter(TAC)in different time periods on the treatment acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 160 patients with STEMI undergoing primary percutaneous coronary intervention received thrombus aspiration by Export TAC and stent implantation after coronary angiography.Based on starting time of using TAC after myocardial ischemia,the patients were divided into observation group(3 to 12 h)and control group(<3 h),with 80 patients in each group.The rates of thrombolysis in myocardial infarction 3 flow grade,postoperative chest pain relief and ST-segment recovery 2 hafter operation were observed and compared between two groups.Results There were no significant differences in the sex ratio,age,the infarct-related artery site and complication rates of hyperlipidemia,hypertension,type 2 diabetes and smoking history between two groups(P>0.05).The rates of thrombolysis in myocardial infarction 3 flow grade,postoperative chest pain relief and ST-segment recovery ≥70% were significantly higher in observation group(80.0%,90.0%,68.8%)than those in control group(38.8%,71.3%,45.0%)(P<0.05).Conclusion Export TAC applied in 3 to 12 hafter STEMI can achieve an optimal result.