血栓抽吸对老年急性ST段抬高型心肌梗死患者直接PCI术的影响
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The Effect of Thrombus Aspiration in the Elderly Patients with Acute ST-segment Elevation Myocardial Infarction During the Direct Percutaneous Coronary Intervention
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    摘要:

    目的 研究血栓抽吸联合直接经皮冠状动脉介入治疗(PCI)对老年急性ST段抬高型心肌梗死(STEMI)患者的疗效。方法 收集荆门市第一人民医院2011年1月至2013年12月因急性STEMI行直接PCI治疗的老年患者108例,年龄60~75岁。分为两组,对照组68例,行单纯PCI术;联合组40例,血栓抽吸联合PCI治疗。比较两组患者的基础资料、术后即刻冠状动脉造影、术后校正TIMI帧数(CTFC)以及住院期间和出院后6个月随访情况。结果 (1)两组间基线一致,具有可比性。(2)联合组术后TIMI血流分级、TIMI血流3级率、术后90 min ST段回落>50%的比率均较对照组高(P<0.05),而术后无复流率、CTFC明显低于对照组(P<0.05);住院期间死亡率未见明显差异(P>0.05)。(3)随访6个月后,两组患者全因死亡率、主要不良心脏事件及心绞痛再次住院率均未见明显差异(P>0.05),但联合组左心室射血分数较对照组明显增高(P<0.05)。结论 血栓抽吸可有效减轻老年急性STEMI患者冠状动脉内的血栓负荷,明显改善PCI术后心肌组织微循环的灌注和心功能。

    Abstract:

    Aim To investigate the effect of thrombus aspiration in the elderly patients with acute ST-segment elevation myocardial infarction (STEMI) during the direct percutaneous coronary intervention (PCI). Methods A total of 108 consecutive acute STEMI elderly patients (60-75 years years old) received PCI in the Frist People's Hospilal of Jingmen enrolled in this study from January 2011 to December 2013. These patients were divided into 2 groups: control group (n=68) who underwent only PCI operation,and combined group (n=40) who underwent thrombus aspiration combined PCI. The basic data,immediate postoperative coronary angiography,postoperative corrected TIMI frame count (CTFC),hospitalization,and follow-up of 6 months after discharge were compared between the two groups. Results (1)The baseline data were identical and comparable in the two groups. (2)Compared with the control group,postoperative thrombolysis in myocardial infarction (TIMI) grade,rate of TIMI 3 and ST segment down back >50% ratio at postoperative 90 minutes were significantly higher,but rate of no-reflow and CTFC were significantly lower in the combined group (P<0.05). There was no significant difference in mortality during hospitalization between the two groups (P>0.05). (3)After follow-up 6 months,there were no statistical differences in total mortality,main adverse cardiac event (MACE) and rehospitalization rate for angina pectoris between the two groups (P>0.05). Left ventricular ejection fraction (LVEF) of combined group was higher than that of control group (P<0.05). Conclusions Thrombus aspiration can effectively reduce thrombus burden in coronary artery for elderly patients with acute STEMI. It can markedly improve microcirculation perfusion of myocardial tissue and cardiac function after PCI operation.

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邓长金,金露萍,成 威,魏国政,邵 玲,彭 娜,徐晓东.血栓抽吸对老年急性ST段抬高型心肌梗死患者直接PCI术的影响[J].中国动脉硬化杂志,2015,23(09):923~926.

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  • 收稿日期:2014-06-03
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  • 在线发布日期: 2015-07-21