血栓抽吸导管联合替罗非班治疗急性ST段抬高型心肌梗死患者的远期疗效研究

目的探讨血栓抽吸导管联合替罗非班治疗急性ST段抬高型心肌梗死患者的远期疗效。方法纳入分析2006年6月~2009年6月间在我院住院行急诊经皮冠状动脉介入（PCI）治疗的急性ST段抬高型心肌梗死患者比例,应用血栓抽吸联合替罗非班治疗为治疗组（n=62）,未应用血栓抽吸及替罗非班治疗为对照组（n=62）,比较两组患者术后的心肌梗死溶栓（TIMI）血流、TIMI心肌灌注分级（TMPG）;住院期间出血并发症、住院期间主要心血管不良事件（MACE）、出院时左室射血分数（LVEF）值;随访2年时的LVEF及期间的MACE。结果治疗组患者术后即刻TIMI血流3级及TMPG3级患者显著高于对照组（P〈0.05）,治疗组患者出院时LVEF值显著高于对照组（P〈0.05）,两组患者住院期间的出血并发症及MACE无统计学差异（P〉0.05）。随访2年时治疗组LVEF值高于对照组（P〈0.05）,MACE低于对照组（P〈0.05）。结论血栓抽吸导管联合替罗非班治疗可显著改善急性ST段抬高型心肌梗死患者术后TIMI血流、TMPG分级及心功能,不增加患者出血风险,且2年后仍可持续获益。

Long-term curative effect of thrombus suction catheter combining tirofiban on acute ST-segment elevation myocardial infarction

Objective To investigate the long-term curative effect of thrombus suction catheter combining tirofiban in the patients with acute ST-segment elevation myocardial infarction （ STEMI ） . Methods The patients with STEMI （ n =124 ） having emergency PCI from June, 2006 to June, 2009 were analyzed retrospectively and then divided into treatment group （ n =62 ） treated with thrombus suction catheter combining tirofiban and control group （ n =62 ） treated without tirofiban and thrombus suction catheter. The grade of thrombolysis in myocardial infarction （ TIMI ） flow and TIMI myocardial perfusion grade （ TMPG ） after treatment, bleeding complications and major adverse cardiovascular events （ MACE ） during hospitalization, value of left ventricular ejection fraction （ LVEF ） when discharging from hospital, LVEF during follow-up for two years and MACE during follow-up period were compared between two groups. Results In treatment group, the patients with TIMI flow grade 3 and TMPG grade 3 were significantly more than those in control group （ P 0.05 ） , value of LVEF was significantly higher than that in control group （ P 0.05 ） , and there was no statistical difference in bleeding complications （ P 0.05 ） and MACE （ P 0.05 ） during hospitalization between two groups. The value of LVEF was higher （ P 0.05 ） after follow-up for two years, and MACE was significantly lower （ P 0.05 ） during follow-up in treatment group than those in control group. Conclusion Thrombus suction catheter combining tirofiban can significantly improve TIMI flow, TMPG grade and heart function in patients with STEMI, which will not promote bleeding risk and has continues curative effect after two years