Objective To analyze the clinical effect and safety of thrombus aspiration combined with percutaneous coronary intervention(pCI)on acute ST - segment elevation myocardial infarction. Methods From 2010 to 2014,a total of 288 patients with acute ST - segment elevation myocardial infarction were selected in Dagang Hospital of New Binhai District, Tianjin,and they were divided into control group ( n = 168 ) and test group ( n = 120 ) according to indication and contraindication of thrombus aspiration. patients of control group received pCI only,while patients of test group received thrombus aspiration combined with pCI. The proportion of 3 - grade TIMI flow,ST - segment depression rate,vascular recanalization rate,incidence of coronary slow flow phenomenon or coronary no - reflow phenomeon,CK-MB,LVEF,LVEDD and incidence of recent cardiac adverse events were compared between the two groups. Results The proportion of 3 - grade TIMI flow,ST - segment depression rate,vascular recanalization rate of test group was statistically significantly higher than that of control group,respectively,while incidence of coronary slow flow phenomenon or coronary no - reflow phenomeon of test group was statistically significantly lower than that of control group( P < 0. 05). CK-MB of test group was statistically significantly lower than that of control group,LVEF of test group was statistically significantly higher than that of control group,while LVEDD of test group was statistically significantly larger than that of control group(P < 0. 05). No statistically significant differences of incidence of ischemic stroke or repeat revascularization of target vessel was found between the two groups( P > 0. 05),while incidence of malignant arrhythmia,of cardiac death,of recurrent myocardial infarction of test group was statistically significantly lower than those of control group,respectionely(P < 0. 05). Conclusion Thrombus aspiration combined with pCI has certain clinical effect in treating acute ST - segment elevation myocardial infarction,can effectively improve the vascular recanalization rate and myocardial reperfusion,reduce the incidence of coronary slow flow phenomenon or coronary no - reflow phenomeon,has relatively high safety.%目的：探究血栓抽吸联合经皮冠状动脉介入术（pCI）治疗急性 ST 段抬高型心肌梗死的临床效果及安全性。方法选取2010—2014年天津市滨海新区大港医院收治的急性 ST 段抬高型心肌梗死患者288例，依据血栓抽吸适应证及禁忌证分为试验组120例和对照组168例。试验组患者给予血栓抽吸联合 pCI 治疗，对照组患者仅行 pCI治疗。比较两组患者治疗后 TIMI 血流分级、ST 段下降情况、血管再通及慢血流/无复流情况、肌酸激酶同工酶（CK-MB）水平、左心室射血分数（LVEF）、左心室舒张末期内径（LVEDD）及近期心脏不良事件发生情况。结果试验组患者治疗后 TIMI 血流分级3级者所占比例、ST 段下降率、血管再通率均高于对照组，慢血流/无复流发生率低于对照组（P <0.05）。试验组患者治疗后CK-MB水平低于对照组，LVEF 高于对照组，LVEDD 大于对照组（ P <0.05）。两组患者缺血性脑卒中、靶血管再次血运重建发生率比较，差异无统计学意义（ P >0.05）；试验组患者恶性心律失常、心源性死亡、再发心肌梗死发生率低于对照组（P <0.05）。结论血栓抽吸联合 pCI 治疗急性 ST 段抬高型心肌梗死患者的临床效果确切，能有效提高血管再通率、降低慢血流/无复流发生率，改善心肌再灌注情况，且安全性较高。
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