摘要
目的应用实时心肌声学造影（RT-MCE）评价经皮血栓吸除术治疗急性心肌梗死（AMI）无复流的疗效。方法将68例证实梗死相关动脉有血栓形成的急性ST段抬高型心肌梗死（STEMI）患者随机分为单纯急诊经皮冠状动脉介入治疗（PCI）组和PCI联合血栓吸除术组,每组34例。于PCI后24h和1周行RT-MCE,记录两组灌注对比积分指数（CSI）、室壁运动积分指数（WMSI）、透壁性对比缺损长度百分比（CDL/LV）和严重室壁运动异常长度百分比（WML/LV）。结果术后24h和1周PCI联合血栓吸除术组CSI、WMSI、CDL/LV和WML/LV较单纯PCI组明显降低,且1周时较24h降低更明显（P〈0.05或P〈0.01）。结论经皮血栓吸除术可明显减少术后无复流的发生,改善微循环以及心脏功能,使PCI对AMI更有效。
Objective To study the efficacy of the percutaneous thrombectomy on no-reflow in the patients with acute myocardial infarction （AMI） with angiographically proven thrombus. Methods A total of 68 patients suffering from AMI with coronary thrombus shown by angiography were randomly divided into a group of percutaneous coronary intervention （PCI） therapy （n=34） and a group of PCI plus percutaneous thrombectomy （n=34）. At 24 hours and 1 week after PCI, real-time imaging was performed by contrast pulse sequencing technology. Contrast score index （CSI）, regional wall motion score index （WMSI）, endocardial length of contrast defect （CDL） and wall motion abnormality （WML） were calculated.Results In patients treated with a percutaneous thrombectomy, CSI, WMSI, CDL/left ventricular length （LV）, and WML/LV were significantly lower than in PCI group at both time points of observation, and these indexes were markedly decreased at 1 week after PCI compared with 24 hours after PCI （P〈0.05 or P〈0.01）. Conclusion The beneficial effect of the thrombectomy occurs at the microvascular level.Thrombectomy reduces the no-flow phenomenon and the extent of microvascular obstruction, thus it is a feasible therapy in patiens with AMI.
出处
《中国危重病急救医学》
CAS
CSCD
北大核心
2007年第11期687-690,共4页
Chinese Critical Care Medicine
关键词
经皮血栓吸除术
心肌梗死
急性
实时心肌声学造影
thrombectomy
acute myocardial infarction
real-time myocardial contrast echocardiography
