血栓抽吸对急性ST段抬高心肌梗死患者的疗效

目的：探讨急性 ST 段抬高心肌梗死（STEMI）患者行急诊冠脉介入治疗（PCI）中使用血栓抽吸的临床疗效及对预后的影响。方法：STEMI 患者105例，其中应用血栓抽吸＋PCI 治疗34例（血栓抽吸＋PCI 组），接受常规 PCI 治疗71例（常规 PCI 组），比较两组患者术后血流恢复及心功能指标的变化以及术后1年内主要不良心血管事件（MACE）及再入院情况。结果：与常规 PCI 治疗组相比，血栓抽吸＋PCI 组血流恢复后的肌酸激酶同工酶CK-MB，（236.62±133.00）ng/ml 比（186.47±69.20）ng/ml]、肌酸激酶（CK）（2833.39±198.70）ng/ml 比（2129.59±199.40）ng/ml]峰值及 CK-MB （12.38±6.70）h 比（9.65±3.90）h]，CK （12.80±8.10）h 比（9.68±3.50）h]峰值时间均显著降低（P 均＜0.05）；随访1年 MACE 事件发生率（19.7％比8.8％）及再入院率（66.2％比50.0％）有下降趋势，但无统计学意义（P ＞0.05）。两组血流恢复与心功能的差异无统计学意义（P ＞0.05）。结论：急诊 PCI 术中血栓抽吸有助于减轻病情，使酶学水平显著下降，可能还改善预后。

Therapeutic effect of thrombus suction in patients with acute ST-segment elevation myocardial infarction

Objective：To explore therapeutic effect and prognosis of thrombus suction in patients with acute ST seg-ment elevation myocardial infarction （STEMI）during percutaneous coronary intervention （PCI）.Methods：A total of 105 STEMI patients were enrolled and divided into thrombus suction ＋ PCI group （n=34,received thrombus suction ＋ PCI therapy）and routine PCI group （n=71,received routine PCI treatment）.Postoperative TIMI flow, cardiac function during hospitalization,incidence of major adverse cardiovascular events （MACE）and rehospitaliza-tion within one-year follow-up after PCI were compared between two groups.Results：Compared with routine PCI group,there were significant reductions in peak values of creatine kinase isoenzyme CK-MB,（236.62± 133.00） ng/ml vs.（186.47±69.20）ng/ml]and creatine kinase CK,（2833.39± 198.70）ng/ml vs.（2129.59± 199.40） ng/ml],peak time of CK-MB （12.38±6.70）h vs.（9.65±3.90）h]and CK （12.80±8.10）h vs.（9.68± 3.50）h]after blood flow recovery,P 〈 0.05 all in thrombus suction ＋ PCI group;there were downtrend of MACE （19.7% vs.8.8%）and rehospitalization rate （66.2% vs.50.0%）in thrombus suction ＋ PCI group,but no significant difference between routine PCI group and thrombus suction ＋ PCI group during one-year follow-up,P 〉0.05. Conclusion：Thrombus suction is help for improving patients condition,reducing enzymology level may be effect improving prognosis.