摘要
目的:研究ST段抬高型心肌梗死患者急诊经皮冠状动脉介入治疗(PCI)术中选择性使用血栓抽吸导管的即刻效果及近期预后。方法:入选因ST段抬高型心肌梗死于我院就诊并行急诊PCI治疗的患者,随机分为常规性血栓抽吸组(50例)和选择性血栓抽吸组(50例)。观察两组PCI术中血栓抽吸的阳性率和抽出血栓的完整性、血流TIMI分级、血栓脱落情况及术后2hST段回落情况。随访术后1个月内主要不良心血管事件。结果:选择性血栓抽吸组26例使用血栓抽吸导管,血栓抽吸阳性率明显高于常规性血栓抽吸组(84.62%︰56.00%,P<0.05)。两组抽到血栓的完整性、血栓脱落和术后即刻TIMI分级未见差异。术后2h常规性血栓抽吸组ST段回落≥50%为41例,选择性血栓抽吸组ST段回落≥50%为39例,两组比较无显著差异。术后1个月随访,两组患者的主要不良心血管事件发生率无显著性差异。结论:ST段抬高型心肌梗死患者急诊PCI术中选择性使用血栓抽吸策略根据低压预扩后判断血栓负荷,提高了判断血栓负荷的准确性和抽吸出血栓的阳性率。
Objective：To study the immediate effect and early prognosis of selective using of thrombus aspiration in patients with ST-segment elevation myocardial infarction（STEMI）during the emergency PCI.Method：Patients with STEMI who underwent emergency PCI were randomly divided into routine thrombus aspiration group（n=50）and selective thrombus aspiration group（n=50）.The positive rate of thrombus aspiration,thrombus integrity,TIMI grading,thrombus falling and ST-segment resolution were observed.Major adverse cardiovascular events 1months after PCI were recorded.Result：In the selective thrombus aspiration group,26 cases used thrombus aspiration catheter,and the positive rate of thrombus aspiration was significantly higher than that in the routine thrombus aspiration group（84.62% vs.56.00%,P〈0.05）.There was no difference between the two groups in thrombus integrity,thrombus falling and TIMI grading.After 2hours of PCI,there was no significant difference in ST-segment resolution between the two groups.After followed-up for one month,the major adverse cardiovascular events in the two groups had no significant difference.Conclusion：For the patients with STEMI during the emergency PCI,the strategy on selective using thrombus aspiration can improve the accuracy of judging thrombus burden and the positive rate of thrombus aspiration.
出处
《临床心血管病杂志》
CAS
CSCD
北大核心
2017年第10期946-949,共4页
Journal of Clinical Cardiology
基金
上海市医学重点专科建设专项基金(No:ZK2015B09)
关键词
ST段抬高型心肌梗死
经皮冠状动脉介入治疗
血栓
抽吸
ST-segment elevation myocardial infarction~ percutaneous coronary intervention
thrombus
aspiration
