两种不同血栓抽吸导管对急性心肌梗死临床效果的对比研究

目的本研究是通过EXPORT XT和DIVER CE血栓抽吸导管对急性心肌梗死（STEMI）血栓抽吸作用的对比研究,探讨两种血栓抽吸导管在急性心肌梗死PCI术中的可行性和临床疗效。方法选择我院使用血栓抽吸导管治疗的STEMI患者,根据血栓抽吸导管分为EXPORT XT组和DIVER CE组,对比观察两种导管血栓抽吸的成功率及其近期临床效果。结果本院2012年2月-2013年6月所有使用血栓抽吸导管治疗的STEMI 328例,EXPORT XT组198例,两组年龄无显著差异（P〉0.05）。EXPORT XT组血栓抽吸成功率略高于DIVER CE组,为96.9%对95.4%（P〉0.05）;TIMIⅢ级血流率和BlushⅢ级血流率也略高,分别为96.9%和50.0%对94.6%和47.7%,但均无显著性差异（均P〉0.05）。术后1-2周左室舒张末内径分别为（52.9±4.9）mm和（53.5±5.4）mm（P=0.67）;左室射血分数分别为（0.51±0.15）和（0.49±0.13）（P=0.58）。结论本研究显示AMI患者PCI术中使用EXPORT XT和DIVER CE血栓抽吸导管抽吸血栓,具有相似的成功率及近期临床效果。

The clinical effect of EXPORT XT compare Diver CE Device for thrombectomy during primary angioplasty in patients with acute myocardial Infarction

Objective ] According to compare EXPORT XT with Diver CE device during primary percutaneous coronary angioplasty（PPCI） in patients with Acute segment elevation myocardial infarction（STEMI）, to assess the feasibility and thrombectomy efficacy of EXPORT XT and Diver CE device in acute STEMI patients. Methods ] All consecutive patients treated with manual thrombectomy for acute STEMI in our hospital were considered. According to the different thrombectomy device, Patients were divided into two groups： EXPORT XT group and DIVER CE group. To compare thrombectomy feasibility （ability to cross the occlusion and the effectiveness of thrombectomy with the device） and short term clinical efficacy （TIMI grade for coronary perfusion, Blush grade for myocardial perfusion after stent implanted, and cardiac function）. Results ] From Feberuy 2012 to June 2013, 328 patients were included： 198 patients （59.1 ± 13.6 years） were treated with EXPORT XT, and 130 patients （59.30 ± 12.8 years, P〉0.05） were treated with DIVER CE. The success rate of thrombectomy in EXPORT XT group is higher than that of DIVER CE group（96.9% versus 95.4%, P〉0.05）; the rates of TIMI III grade and Blush III grade after PPCI were higher in the EXPORT XT group than the DIVER CE group（96.9% versus 94.6%, and 50.0% versus 47.7%, all P〉0.05）, but they are no significant different. In both groups, there were no significant difference in cardiac function （LVDED 52.9 ± 4.9mm for EXPORT XT group and 53.5 ± 5.4mm for DIVER CE group, P=0.67. LVEF 0.51 ± 0.15 for EXPORT XT group and 0.49 ± 0.13 for DIVER CE group , P=0.58） after 1-2 weeks manual thrombus aspiration combined stent implanted. Conclusion ] The present study suggests that, in the setting of acute STEMI, EXPORT XT and DIVER CE throbectomy device have similar feasibility and short term clinical efficacy during the PPCI.