摘要
目的 探讨应用血栓抽吸对行直接经皮冠状动脉介入治疗（PCI）的急性ST段抬高型心肌梗死（STEMI）患者Tp-e及Tp-e/QT的影响.方法 选取同期发病12h内行直接PCI罪犯血管（IRA）内存在血栓负荷重的STMEI患者110例,随机分成血栓抽吸组（血栓抽吸＋PCI）及对照组（单纯PCI）.测量两组PCI术前及术后2h心电图中Tp-e及Tp-e/QT,并观察两组在住院期间发生恶性心律失常的情况.结果 两组在性别、年龄、心血管风险因子、症状发作至球囊扩张时间、PCI术前Tp-e及Tp-e/QT等方面比较未见统计学差异（P＞0.05）.血栓抽吸组PCI术后ST段回落＞70％的比率、Tp-e及Tp-e/QT减少的幅度均高于对照组[60.00％比40.00％,（22.66±9.91）ms比（15.89±8.24）ms,0.04±0.03比0.03±0.02,P均＜0.05];血栓抽吸组PCI术后Tp-e、Tp-e/QT及术后至出院前发生恶性心律失常的比率均低于对照组[（88.54±13.13）ms比（93.7l±11.00）ms,0.25±0.03比0.26±0.03,16.00％比33.33％,P均＜0.05].结论 对于冠状动脉内血栓负荷重的急性STEMI患者,直接PCI术时应用血栓抽吸可以更多地减少心室复极离散度指标Tp-e及Tp-e/QT,降低心肌梗死后恶性室性心律失常发生的风险.其原因可能与血栓抽吸有助于更好地恢复微循环再灌注水平有关.
Objective To investigate the effect of thrombus aspiration on Tp-e and Tp-e/QT ratio in acute ST segment elevation acute myocardial infarction（STEMI） patients who underwent primary percutaneous coronary intervention.Methods 110 patients who were admitted to the hospital underwent PCI within 12 hours after onset of acute STEMI and randomly divided into thrombus aspiration group （thrombus aspiration＋PCI） and control group （simple PCI）.The Tp-e and Tp-e/QT ratio in the ECG in each patient was calculated before and after 2 hours PCI.Observed high risk ventricular arrhythmia（VA） in two groups during hospitalization.Results The gender,age,cardiovascular risk factors,symptom-onset-to-balloon time,Tp-e and Tp-e/QT ratio before PCI and so on have no significant differences between two groups.The ratio of ST-segment resolves （STR） greater than 70％,the reduction of Tp-e and Tp-e/QT ratio after PCI in thrombus aspiration group are higher than the control group[60.00％ vs 40.00％,（22.66±9.91）ms vs （15.89±8.24）ms,0.04±0.03 vs 0.03±0.02,P＜0.05].The Tp-e and Tp-e/QT ratio after PCI in thrombus aspiration group are lower than the control groups;and is also the occurrence of high risk VA during after PCI to discharge period[（88.54±13.13）ms vs （93.71±11.00）ms,0.25±0.03 vs 0.26±.0.03,16.00％ vs 33.33％,P＜0.05].Multivariate logistic regression analysis showed that thrombus aspiration was a protective factor in high-risk ventricular arrhymia during after PCI to discharge period.Conclusion Thrombus aspiration can reduce more ventricular repolarization dispersion index Tp-e and Tp-e/QT ratio in patients with STEMI who underwent primary PCI,and reducing the risk of high-risk ventricular arrhythmia.The reason may be thrombus aspiration is helpful to recover the microcirculation reperfusion.
出处
《中国心血管病研究》
CAS
2017年第8期702-706,共5页
Chinese Journal of Cardiovascular Research
