应用EXPORT血栓抽吸导管在急性ST段抬高型心肌梗死直接经皮冠状动脉介入治疗中的有效性观察

摘要

Objective:To evaluate the efficacy of thrombus aspiration during primary percutaneous coronary intervention(PCI)for treating the patients with acute ST-segment elevation myocardial infarction(STEMI).rnMethods:A total of 108 patients with coronary angiography confirmed acute STEMI and heavy thrombus load were summarized. The patients were randomized into two groups, Experimental group, n - 53, the patients were treated by primary PCI plus thrombus aspiration,and Control group,n. = 55,the patients received conventional PCI. The TTMI blood flow,corrected TTMI frame, TIMI grade,ST-segment elevation recovery and the peak values of plasma creatine kinase MB( CK-MB) and cardiac troponin I (CTNI)were assessed and compared between two groups.rnResults;Compared with Control group,the Experimental group presented significantly improved post-procedural TIMI blood flow,corrected TIMI frame,TIMI grade blood flow,and the better recovery of ST-segment elevation,P<0. 05 or P<0. 01. The patients in Experimental group also showed obviously lower peak values of CK-MB and CTNI,P<0. 05.rnConclusion; Primary PCI plus thrombus aspiration could improve myocardial reperfusion, decrease the peak value of plasma CK-MB and CTNI in patients with acute STEMI.%目的:研究急性ST段抬高型心肌梗死(STEMI)直接经皮冠状动脉介入治疗(PCI)中血栓抽吸对各项心肌灌注和临床指标的影响.方法:108例冠状动脉造影证实血栓负荷重的急性STEMI患者,随机分为血栓抽吸+PCI组(n=53)及传统PCI组(n=55),比较两组术后心肌梗死溶栓治疗临床试验(TIMI)血流分级、校正TIMI帧数、TIMI心肌灌注分级、ST段抬高回落百分比、血浆肌酸激酶MB同工酶、肌钙蛋白Ⅰ峰值及术后30天主要心脏不良事件发生率的差别.结果:血栓抽吸+PCI组TIMI血流分级、校正TIMI帧数、TIMI心肌灌注分级、ST段抬高回落百分比均明显优于传统PCI组(P＜0.05或0.01),且血浆肌酸激酶MB同工酶、肌钙蛋白Ⅰ峰值显著低于传统PCI组(P＜0.05),差异均有统计学意义.结论:STEMI直接PC中应用血栓抽吸可以改善血流及心肌灌注情况、降低心肌标志物峰值.