论文部分内容阅读
目的:研究急性ST段抬高型心肌梗死(STEMI)直接经皮冠状动脉介入治疗(PCI)中血栓抽吸对各项心肌灌注和临床指标的影响。方法:108例冠状动脉造影证实血栓负荷重的急性STEMI患者,随机分为血栓抽吸+PCI组(n=53)及传统PCI组(n=55),比较两组术后心肌梗死溶栓治疗临床试验(TIMI)血流分级、校正TIMI帧数、TIMI心肌灌注分级、ST段抬高回落百分比、血浆肌酸激酶MB同工酶、肌钙蛋白I峰值及术后30天主要心脏不良事件发生率的差别。结果:血栓抽吸+PCI组TIMI血流分级、校正TIMI帧数、TIMI心肌灌注分级、ST段抬高回落百分比均明显优于传统PCI组(P<0.05或0.01),且血浆肌酸激酶MB同工酶、肌钙蛋白I峰值显著低于传统PCI组(P<0.05),差异均有统计学意义。结论:STEMI直接PCI中应用血栓抽吸可以改善血流及心肌灌注情况、降低心肌标志物峰值。
Objective: To study the effects of thrombus aspiration on myocardial perfusion and clinical indexes in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing direct percutaneous coronary intervention (PCI). Methods: A total of 108 acute STEMI patients with coronary artery thrombosis confirmed by coronary angiography were randomly divided into thrombus aspiration + PCI group (n = 53) and conventional PCI group (n = 55). Thrombolysis after myocardial infarction TIMI flow classification, corrected TIMI frames, TIMI myocardial perfusion grading, ST-segment elevation fall-off percentage, plasma creatine kinase MB isoenzyme, troponin I peak, and major cardiac adverse events 30 days after surgery Rate difference. Results: TIMI flow rate, TIMI frame, TIMI myocardial perfusion grading and ST-segment elevation percentage in PCI group were significantly better than those in PCI group (P <0.05 or 0.01), and plasma creatine kinase MB Isoenzyme, troponin I peak was significantly lower than the traditional PCI group (P <0.05), the differences were statistically significant. Conclusion: The application of thrombus aspiration in STEMI direct PCI can improve the blood flow and myocardial perfusion and decrease the peak of myocardial markers.