PCI联合血栓抽吸术治疗急性ST段抬高型心肌梗死的效果

目的 探究经皮冠状动脉介入术（PCI）联合血栓抽吸术治疗急性ST段抬高型心肌梗死（STEMI）的效果。方法 选取2014年11月—2017年11月我院收治的86例STEMI患者作为对象，经随机数字表法将之均分为两组，单纯PCI组行PCI治疗，联合组行血栓抽吸+PCI治疗，此外，两组均予盐酸替罗非班治疗。比较两组术后TIMI血流分级情况、支架植入2h后一般情况及主要不良心血管事件（MACE）发生情况。结果 支架植入后，联合组TIMI血流分级Ⅱ级+Ⅲ级患者的比例95.3%（41/43）显著高于单纯PCI组76.7%（33/43）（P＜0.05）；支架植入2h后，观察组cTnT峰值及CK-MB峰值显著低于对照组，ST段回落＞50%的比例及术后10d的LVEF显著高于对照组（P＜0.05）；住院期间和术后5个月内，两组MACE发生率相比，差异无统计学意义（P＞0.05）。结论 PCI联合血栓抽吸术治疗STEM能够有效改善冠脉血流和左心室功能，促进梗死区域的心肌灌注，改善患者短期预后。

PCI combined with thrombus aspiration in the treatment of acute ST elevation myocardial infarction effect

Objective: To explore the effect of percutaneous coronary intervention (PCI) combined with thrombus aspiration in the treatment of acute ST segment elevation myocardial infarction (STEMI). Methods: 86 cases of STEMI patients treated in our hospital from November 2014 to November 2017 were divided into two groups by random digital table. PCI treatment was performed in group PCI alone, and the combined group was treated with thrombus aspiration. In addition, the two groups were treated with tirohydrochloric acid. The postoperative TIMI blood flow grading, the general situation and the main adverse cardiovascular events (MACE) of the two groups were compared between the two groups after 2H implantation. Results: after the stent implantation, the proportion of TIMI blood flow classification II + III patients in the combined group was 95.3% (41/43) significantly higher than that of the simple PCI group (33/43) (P < 0.05). After the stent implantation 2h, the peak value of cTnT and the peak value of CK-MB in the observation group were significantly lower than those of the control group. The ratio of the ST segment down to 50% and the LVEF of 10d after the operation were significantly higher than those of the control group. (P < 0.05), there was no statistically significant difference in the incidence of MACE between the two groups (P > 0.05) in the 5 months after hospitalization. Conclusion: PCI combined with thrombus aspiration in the treatment of STEM can effectively improve the coronary flow and left ventricular function, promote myocardial perfusion in the infarct area, and improve the short-term prognosis of the patients.