急诊 PC I支架释放后对不同管径血管再次血栓抽吸的疗效研究

摘要

目的：探讨不同管径血管，在急性心肌梗死（AMI）急诊经皮冠状动脉介入治疗（PCI）中支架释放后再次应用血栓抽吸导管对改善心肌组织灌注和临床预后的作用。方法205例AMI患者经血栓抽吸后即刻植入支架，分别比较小于3．0 mm的血管和大于或等于3．0 mm血管常规血栓再抽吸组和不抽吸组术中心肌梗死溶栓治疗试验血流分级（TIMI）血流情况、术后心电图演变，30 d内、6个月内主要不良心脏事件（MACE）。结果≥3．0 mm血管中再次血栓抽吸组 TIMI 3级血流比例、6个月内MACE有明显改善，＜3．0 mm的血管中没有发现有益的作用。结论在急性ST段抬高心肌梗死（STEMI）急诊PCI中，对于大于或等于3．0 mm血管植入支架后常规进行再次血栓抽吸，可能会改善梗死相关血管前向血流情况，降低M ACE。%Objective To assess under different vessel diameter ,the effect of the aspiration thrombectomy catheter in improving the myocardial reperfusion and clinical prognosis in patients with acute myocardial infarction (AMI)who were undergone primary percutaneous coronary intervention(PCI) .Methods 205 patients with AMI immediate implant stents after thrombus suction ,the TIMI flow grade(myocardial infarction thrombolysis treatment test flow classification ) ,postoperative ecg evolution ,incidence of no-reflow MACE in 30 days and MACE in 6 months were compared between conventional thrombus suction group and suction again group(blood vessels of <3 .0 mm and ≥3 .0 mm) .Results The level 3 blood flow rate ,MACE in 6 months in suction again group with blood vessels of ≥3 .0 mm had improved significantly ,but had no beneficial effects in blood vessels of ≥3 .0 mm .Conclusion In AMI patients treated with primary PCI ,application of aspiration thrombectomy catheter with blood vessels of ≥3 .0 mm may im-prove the flow condition before infarction related blood vessels ,reduce MACE .