【摘要】 目的:评价直接冠状动脉介入治疗(PCI)前血栓抽吸对急性ST段抬高心肌梗死患者心肌再灌注的影响。方法:入选2006年1月至2007年8月98例梗死相关血管(IRA)前向血流TIMI 0级的急性ST段抬高心肌梗死患者,随机分为血栓抽吸+PCI组49例和标准PCI组49例。观察ST段回落指数、MBG评分、左室射血分数和院内主要心脏不良事件(心性死亡、急性心肌梗死和再次血运重建)。结果:血栓抽吸+PCI组ST段完全回落比例明显高于标准PCI组(37/49vs.24/49,P<O.05),MBG评分亦好于标准PCI组[(2.86±0.28)vs.(2 36±0.48),P<0.05],远端栓塞发生率低于标准PCI组(2/49 vs.9/49.P<0.05)。两组的CK峰值、左室射血分数和MACE发生率无统计学差异。结论:STEMI患者直接PCI术前使用血栓抽吸装置可以减少血栓负荷.改善心肌微循环灌注水平。更多还原

【Abstract】 Objective:To investigate the impact of thrombus aspiration in acute ST-segment elevation myocardial infarction patients under- going primary percutaneous coronary intervention ( PPCI).Methods:From Jan 2006 to Aug 2007,98 acute myocardial infarction patients with angiographic evidence of coronary thrombus were subjected to either PCI plus thrombus aspiration group (treatment group,n =49) or standard PCI group ( control group,n = 49 ).ST segment resolution,myocardial blush grade ( MBG),left ventricular ejection fraction,and major adverse cardiac events ( cardiac death,acute myocardial infarction or ischemia driven revascularization) in-hospital were observed.Results;The ratio of complete ST-segment resolution of treatment group was significantly higher than that of control group (37/49vs.24/49,P <0.05).The MBG was significantly higher among patients treated with thrombus aspiration compared with standard PCI [(2.86 ±0.28) vs.( 2.36 ± 0.48 ),P < 0.05].The rate of distal embolization of treatment group was significantly lower than that of control group (2/49vs.9/49,P <0.05).The peak creatine kinase value,left ventricular ejection fraction,and MACE were similar in the 2 groups.Conclusions:Manual thrombus aspiration be- fore PPCI leads to lower thrombus burden and is associated with better myocardial reperfusion.更多还原