血栓抽吸导管在ACS急诊PCI中的临床应用研究

目的探讨血栓抽吸导管治疗在ACS常规急诊PCI中的临床疗效。方法选择2010年1月-2011年5月我院住院行急诊经皮冠状动脉介入（PCI）治疗的93例急性ST段抬高型心肌梗死和高危、极高危非ST段抬高急性冠脉综合症（ACS）患者,随机分为联用ThrombusterⅡ血栓抽吸导管治疗为A组（51例）,同期未应用血栓抽吸导管治疗为B组（42例）。比较两组患者术后心肌梗死溶栓（TIMI）血流、校正TIMI帧数（CTFC）、术后心肌呈色分级（BMG）、术后ST段抬高回落幅度及左心室射血分数（LVEF）、住院期间主要心血管不良事件（MACE）有无差异。结果 A组TIMI血流3级、CTFC、BMG、术后ST段抬高回落幅度及LVEF均优于B组,差异均有统计学意义（P〈0.05）。两组患者院内MACE发生率比较,差异无统计学意义（P〉0.05）。结论在ACS常规急诊PCI中联用ThrombusterⅡ血栓抽吸导管治疗可显著改善患者TIMI血流、心肌组织水平灌注及术后心功能,但住院期间MACE的发生率无差异。

Clinical Study on Application of Thrombus Aspiration Catheter in Primary PCI Treatment of Patients with Acute Coronary Syndrome

Objective To evaluate the application of Thrombuster thrombus aspiration catheter in primary PCI treatment of patients with acute coronary syndrome.Methods 51 ACS patients were treated with primary PCI plus ThrombusterⅡ thrombus aspiration catheter（A group） and 42 ACS patients were treated only with routine primary PCI（Bgroup）.The regression rate of TIMI,CTFC,BMG,ST segment,LVEF,incidence of no-reflow/slow-flow、mortality and MACE were followed up after PCI during hospitalization.Results The difference of TIMI、CTFC、BMG、ST segment、LVEF、incidence of no-reflow/slow-flow between the two groups was statistically significant（P〈0.05）,mortality and incidence of MACE followed up after PCI during hospitalization didn＇t reduce.Conclusion Transcatheter aspiration of coronary thromus using ThrombusterⅡ thromus aspiration catheter followed by direct stenting is an effective method to decrease morbidity of no-reflow/slow-flow and improve heart function during emergency PCI in ACS patient.