血栓抽吸术在急性心肌梗死介入治疗中的应用

目的探讨血栓抽吸术+择期经皮冠状动脉介入治疗术在急性心肌梗死介入治疗中应用的有效性和安全性。方法选择2008年8月至2010年10月株洲市一医院接受冠状动脉介入治疗的急性ST段抬高型心肌梗死患者52例,分成血栓抽吸术+择期经皮冠状动脉介入治疗术组与血栓抽吸术+标准经皮冠状动脉介入治疗术组,比较两组间2 h内患者胸痛缓解率、ST段回落率、肌酸激酶及同工酶峰值、心肌梗死溶栓血流分级、左心室射血分数、是否支架植入及术后1个月内不良心血管事件。结果两组术后靶血管心肌梗死溶栓血流、术后2 h ST段回落(ST段回落较ST基线>50%)、2 h内患者胸痛缓解率、心肌梗死溶栓血流分级、肌酸激酶及同工酶峰值、5～7天后左心室射血分数、术后1个月内不良心血管事件发生率差异无显著性(P>0.05)。血栓抽吸术+择期经皮冠状动脉介入治疗术组支架植入构成比明显低于血栓抽吸术+标准经皮冠状动脉介入治疗术组。结论血栓抽吸术是急性心肌梗死直接介入治疗的一种安全而有效的治疗手段,能有效改善心肌灌注。血栓抽吸术+择期经皮冠状动脉介入治疗术在急性心肌梗死介入治疗中应用的有效性和安全性均较好,有一定临床参考价值。

The Use of Thrombus Aspiration Without Additional Ballooning or Stenting in Acute Myocardial Infarction

AimTo evaluate the efficacy and safty of thrombus aspiration without additional ballooning or stenting to treat patients with ST-elevation myocardial infarction.MethodsWe report the angiographic and clinical outcome of a series of selected ST-elevation myocardial infarction patients undergoing mechanical reperfusion by thrombus aspiration with or without additional ballooning or stenting.Thoracalgia and elevated ST segment resolution rate 2 hours after intervention, peak values of creatine kinase (CK) and creatine kinase-MB (CK-MB), left ventricular ejection fraction (LVEF) in 5-7 days, stenting and secondary outcomes 1 month after intervention were compared.ResultsThe rate of stenting in group A is significantly lower than group B; other index were not significantly different from these two groups.ConclusionIn selected patients with ST-elevation myocardial infarction undergoing mechanical reperfusion, thrombus aspiration without additional ballooning or stenting may be successfully performed.