摘要
目的研究血栓抽吸对急性ST段抬高型心肌梗死经皮冠状动脉介入治疗术(PCI)后患者心肌损伤程度的影响。方法选择2014年1月—2016年12月期间在上海市普陀区中心医院接受经皮冠状动脉介入治疗的450例急性心肌梗死患者进行筛选,共353例纳入研究。根据支架植入术前是否行血栓抽吸分为血栓抽吸组(178例)和直接PCI(175例),评估两组患者的心肌损伤程度。结果两组临床基线资料和造影特征比较,差异无统计学意义(P> 0.05)。血栓抽吸组CK-MB峰值、c TnI峰值明显低于对照组(32±42.68) vs (46±67.24)(t=2.25,P=0.020)和(52.3±96.24) vs (79.6±118.45)(t=2.37,P=0.018)。此外,血栓抽吸组患者的CRP、中性粒细胞/淋巴细胞比值(neutrophil-lymphocyte ratio (NLR))低于对照组(9.2±16.36) vs (16.3±38.42)(t=2.26,P=0.025)和(8.2±7.73) vs (10.1±9.64)(t=2.04,P=0.042)。结论经皮冠状动脉介入治疗术联合血栓抽吸急性心肌梗死患者心肌损伤的程度,而血栓抽吸减轻炎症反应可能是减少心肌损伤的机制之一。
Objective To study the effect of thrombus aspiration on myocardial injury in patients with acute ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention(PCI).Methods A total of 450 patients with acute myocardial infarction who underwent percutaneous coronary intervention at the Putuo District Central Hospital in Shanghai from January 2014 to December 2016 were enrolled.A total of 353 patients were included in the study.According to whether thrombus aspiration was performed before stent implantation,the thrombus aspiration group(178 cases)and the Direct PCI group(175 cases)were used to evaluate the degree of myocardial damage in the two groups.Results There were no significant differences in clinical baseline data and angiographic features between the two groups(P>0.05).The peak of CK-MB and cTnI in the thrombus aspiration group were significantly lower than those in the control group(32±42.68)vs(46±67.24)(t=2.25,P=0.020)and(52.3±96.24)vs(79.6±118.45)(t=2.37,P=0.018).In addition,the CRP and neutrophil-lymphocyte ratio(NLR)of the thrombus aspiration group were lower than those of the control group(9.2±16.36)vs(16.3±38.42)(t=2.26,P=0.025)and(8.2±7.73)vs(10.1±9.64)(t=2.04,P=0.042).Conclusion Percutaneous coronary intervention combined with thrombus aspiration in patients with acute myocardial infarction,and thrombus aspiration to reduce inflammation may be one of the mechanisms to reduce myocardial injury.
作者
王超凡
汪志华
刘宗军
WANG Chao-fan;WANG Zhi-hua;LIU Zong-jun(Department of Cardiology,Putuo Hospital,Shanghai University of Traditional Chinese Medicine,Shanghai,200062 China)
出处
《系统医学》
2019年第5期60-63,共4页
Systems Medicine
基金
上海市医学重点专科建设计划项目(ZK2015A17)
关键词
急性ST段抬高性心肌梗死
血栓抽吸
心肌损伤
炎症
Acute ST-segment elevation myocardial infarction
Thrombus aspiration
Myocardial injury
Inflammation
