摘要
目的探讨DIVER^TMCE血栓抽吸导管在急诊PCI中应用的有效性和安全性。方法将78例行急诊介入治疗（PCI）的急性ST段抬高型心肌梗死（STEMI）患者分为血栓抽吸组（30例）及常规PCI组（48例）。比较两组患者术后即刻梗塞相关区域的心肌组织灌注分级（TMP）、术后12h ST段回落情况以及术后3个月的主要心血管事件的发生情况。结果78例研究对象中，冠状动脉造影提示36例（46．15％）存在血栓，术前46例（58.62％）TMP 0～1级。血栓抽吸组术后TMP 0～1级明显少于常规PCI组（P〈0.05），术后TMP3级明显多于常规PCI组（P〈0.05），但两组间术后TMP2级发生率并无明显差异（P〉0.05）；血栓抽吸组术后梗死相关导联ST段回落多于常规PCI组（P=0.05）；两组术后3个月主要心血管事件发生率无明显差异（P〉0．05）。血栓抽吸组无一例抽吸相关并发症发生。结论在STEMI患者的急诊PCI中应用DIVERTMCE血栓抽吸导管安全可行，而且可以显著改善心肌组织灌注，提高梗死相关导联ST段回落率。
Objective To evaluate the efficacy and safety of DIVERTMCE aspiration catheter in primary percutaneous coronary intervention （PCI） of acute myocardial infarction. Methods Seventy eight patients of ST segment elevation acute myocardial infarction（STEMI）, who underwent primary coronary intervention from April 2006 to April 2008 in Ningbo First Municipal Hospital, were divided into aspiration plus PCI group （30 patients） and routine PCI group （48 patients）. Myocardial blush grades, ST segments resolution 12h after the procedure and major adverse cardiac event （MACE） during 3 months follow-up were compared between two groups. Results Before procedure among 78 patients, thrombus was suggested by coronary angiography in 36 （46.15%） ; and flow of target vessel was TMP 0-1 in 46 （58.62%）. There was no significant difference between two groups in clinical and coronary angiographic baseline data. There were less myocardial blush grade 0-1 cases （6.66% vs 27.08%, p=0.021 ）, more myocardial blush grade 3 cases （53.33% vs 31.25%, P=0.028 ） in aspiration group than routine group. But there was no difference in the frequency of myocardial blush grade 2 between two groups （43.33% vs 41.67%, p=0.871 ）. ST segments resolution more than 50% of infarction related leads 12h after the procedure occurred more frequently in aspiration group than routine group, but there was no difference concerning 3 months MACE, including death, recurrent MI and repeated target vessel revascularization, between two groups. In addition, there were more direct stenting in aspiration group （83.33% vs 10.41% ,P 〈0.001 ）than routine group. And there was no case of complication related to aspiration. Conclusion Aspiration with DIVERTMCE catheter in primary PCI of STEMI improved myocardial reperfusion and ST segments resolution.
出处
《浙江医学》
CAS
2009年第4期441-443,共3页
Zhejiang Medical Journal
关键词
血栓抽吸
心肌梗死
介入治疗
Thrombus Myocardial infarction Aspiration Intervention
