血栓抽吸在老年急性ST段抬高型心肌梗死患者直接介入治疗中的应用

目的：研究血栓抽吸在老年急性ST段抬高型心肌梗死(STEMI)患者直接介入治疗中的应用价值。方法回顾性分析2014年1月至2016年1月期间于我院接受直接介入治疗的82例STEMI患者的临床资料。其中41例行常规直接介入治疗患者作为对照组，另41例行直接介入术联合血栓抽吸患者作为观察组，比较两组患者术后的血浆肌酸激酶同工酶(CK-MB)、肌钙蛋白水平，治疗1周与治疗6个月后左室射血分数(LVEF)水平，术后TIMI心肌灌注分级情况以及术后主要心脏不良事件发生情况。结果观察组患者术后CK-MB和肌钙蛋白水平分别为(162.4±32.5) ng/mL、(16.8±3.8) ng/mL，均明显低于对照组的(288.3±55.9) ng/mL、(27.9±4.2) ng/mL，差异均有统计学意义(P<0.05)；治疗6个月后，观察组患者的LVEF水平为(54.7±6.8)%，明显高于对照组的(50.2±10.3)%，差异有统计学意义(P<0.05)；观察组患者术后TIMI心肌灌注3级人数占68.29%，明显高于对照组的41.46%，而0~1级人数占4.88%，明显低于对照组的21.95%，差异均有统计学意义(P<0.05)；观察组患者术后主要心脏不良事件总发生率为2.44%，明显低于对照组的17.07%，差异有统计学意义(P<0.05)。结论血栓抽吸可有效改善老年急性ST段抬高型心肌梗死患者行直接介入治疗后的TIMI血流，且能改善6个月后LVEF，并能有效降低术后主要心脏不良事件发生率。

Application of thrombus aspiration in the treatment of elderly patients with acute ST segment elevation myocardial infarction

Objective To study the value of thrombus aspiration in the treatment of elderly patients with acute ST segment elevation myocardial infarction (STEMI). Methods Retrospective analysis was performed based on the clinical data of 82 patients with STEMI who admitted to our hospital for treatment from January 2014 to January 2016. Among them, 41 patients who underwent conventional direct interventional therapy were selected as the control group, and 41 patients who underwent direct intervention and thrombus aspiration were selected as the observation group. The levels of postoperative plasma creatine kinase MB isoenzyme (CK-MB), cardiac troponin, left ventricular ejection frac-tion (LVEF) 1 week and 6 months after the treatment, postoperative TIMI myocardial perfusion grading and the inci-dence of postoperative major adverse cardiac events were compared. Results The levels of CK-MB and cardiac tropo-nin in the observation group were respectively (162.4±32.5) ng/mL and (16.8±3.8) ng/mL, which were significantly low-er than (288.3±55.9) ng/mL and (27.9±4.2) ng/mL in the control group (P<0.05). After 6 months of the treatment, the level of LVEF in the observation group was (54.7±6.8)%, which was significantly higher than (50.2±10.3)%in the con-trol group (P<0.05). The ratio of postoperative TIMI myocardial perfusion grade 3 in the observation group was 68.29%, which was significantly higher than 41.46% of the control group; the ratio of postoperative TIMI myocardial perfusion grade 0 and 1 level was 4.88%, which was significantly lower than 21.95%of the control group (P<0.05). The total incidence rate of major adverse cardiac events in the observation group was 2.44%, which was significantly lower than 17.07%of the control group (P<0.05). Conclusion Thrombus aspiration can effectively improve the postoperative TIMI flow of the elderly patients with acute ST segment elevation myocardial infarction underwent direct intervention treatment and the levels of LVEF after 6 months of the treatment, which can also effectively reduce the incidence of ma-jor postoperative adverse cardiac events.