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经皮血栓吸除术治疗老年人急性心肌梗死无复流的临床观察 被引量：3

The efficacy of the thrombectomy for the no-reflow of acute myocardial infarction in elderly patients
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摘要 目的采用实时心肌声学造影（RT-MCE），评价经皮血栓吸除术治疗老年人急性心肌梗死（AMI）无复流的疗效。方法46例老年AMI患者，随机分为经皮冠状动脉介入治疗（PCI组）23例和PCI联合血栓吸除术组（联合组）23例。于PCI术后24h和1周行RT-MCE。记录各组灌注对比积分指数（CSI）、透壁性对比缺损长度百分数[CDL／LV length（％）]、室壁运动积分指数（WMSI）和严重室壁运动异常长度百分数[WML／LV length（％）]。结果24h和1周，联合组CSI、CDL／LV length、WMSI和WML／LV length均较PCI组降低[分别为（2．0±0．3）与（2．5±0．7）、（1．5±0．4）与（2．0±0．5）、（15．5±5．4）％与（22．8±4．9）％、（9．6±2．5）％与（21．5±4．6）％，（2．1±0．5）与（2．4±0．7）、（1．5±0．5）与（2．1±0．5）、（24．5±5．3）％与（35．6±8．3）％、（15．9±5．0）％与（27．6±6．4）％]，差异均有统计学意义（P〈0.05或P〈0.01）。结论经皮血栓吸除术可明显减少患者术后无复流的发生，改善微循环和心脏功能，使PCI治疗老年人AMI更有效。 Objective To study the efficacy of the percutaneous thrombectomy for the no-reflow of acute myocardial infarction （AMI） in elderly patients with angiographically proven thrombus. Methods A total of 46 patients（≥60 years old） with AMI and coronary thrombus shown by angiography were randomly divided into group of PCI therapy（23 cases） and group of PCI plus percutaneous thrombectomy（23 cases）. At 24 hours and 1 week after PCI, real-time imaging was performed by contrast pulse sequencing technology. Contrast score index （CSI）, endocardial length of contrast defect（CDL） , regional wall motion score index（WMSI） and wall motion abnormality （WML） were calculated. Results At each time point, in patients treated with a percutaneous thrombectomy, CSI, CDL/LV length （%）, WMSI and WML/LV length（%） were significantly lower than in PCI group[（2.0±0.3） vs. （2.5±0.7）, （1.5±0.4）vs. （2.0±0.5）, （15.5±5.4）% vs. （22.8±4.9） %, （9.6±2.5）% vs. （21.5±4.6）%, （2.1±0.5）vs. （2.4±0.7）, （1.5±0.5）vs. （2.1±0.5）, （24.5± 5.3）% vs.（35.6±8.3）%,（15.9±5.0）vs.（27.6±6.4）%,P〈0.05 or P〈0.01]. Conclusions The beneficial effect of the thrombectomy occurs at the microvascular level. Thrombectomy reduces the no-flow and the extent of microvascular obstruction, thus it was a feasible therapy in elderly patiens with AMI.
作者 潘薇 王岚峰 杨树森 李竹琴 周立君 李悦 李为民
机构地区 哈尔滨医科大学附属第一临床医院心内科CCU病房
出处 《中华老年医学杂志》 CAS CSCD 北大核心 2008年第6期420-423,共4页 Chinese Journal of Geriatrics
基金 基金项目：黑龙江省科技攻关计戈4项目资助（GC07C343）
关键词 血栓 心肌梗死 超声检查 Thrombsis Myocardial infarction Ultrason ography
分类号 R686 [医药卫生—骨科学]
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参考文献12

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二级参考文献17

共引文献17

同被引文献53

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中华老年医学杂志
2008年 第6期

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