摘要
目的评价DiverCE血栓抽吸导管在血栓负荷较大的急性心肌梗死(AMI)患者的经皮冠状动脉介入治疗(PCI)应用中的有效性和安全性。方法30例急诊冠状动脉造影提示血栓负荷较大的AMI患者,在介入治疗时采用DiverCE血栓导管对梗死相关血管内血栓进行抽吸,观察抽吸前后的血栓负荷和血流情况,并以同期采用常规急诊PCI治疗的28例AMI患者作为对照组。结果DiverCE+PCI组30例患者冠脉造影均提示大量血栓征象,抽吸后梗死相关血管血栓负荷明显降低,血流TIMI分级及TMP分级均较单纯PCI组明显改善(P均<0.05);术后肌酸激酶(CK)和肌酸激酶同工酶(CK-MB)峰值较低,ST段回落幅度大,近期左室射血分数高于对照组(P<0.05),左室舒张末期内径小于对照组(P均<0.05)。结论与常规PCI比较,在血栓负荷较重的AMI患者中应用DiverCE血栓抽吸导管安全可行,能有效地减少AMI患者梗死相关血管内的血栓负荷,显著改善患者术后即刻的远端心肌血流灌注,但远期疗效尚需进一步评价。
Objective To assess the efficiency and safety of the Diver CE aspiration thrombeetomy catheter in the percutaneous coronary intervention （PCI）of acute myocardial infarction（AMI） with large thrombus burden. Methods A total of 58 consecutive patients with STEMI were enrolled. 30 cases of AMI in which Diver CE Catheter was used in 30 cases of AMI when they were treated with PCI, and 28 cases of AMI were treated with standard PCI. Results Significant thrombus sign were observed in all of the 30 patients. After the thrombus extraction, the TIMI flow grades and TMP grades were significantly improved and there were lower peak serum CK-MB and CK（ [ CK： （ 1512. 7 ± 75.5）U/L vs （1769.2±83.6） U/L ; CK-MB：（148.5±32.2 ） U/L vs （237.5 ±28.7） U/L , P 〈 0. 05 ] , faster ST segment resolution[ （67.2 ± 28.1） % vs （42.1 ± 34.2） %, P 〈 0.05] and better LVEF and LVEDD in the group of Diver CE. Conclusion In some AMI patients with thrombosis burden , application of Diver CE was safe and effective, which could lower thrombosis burden and improve distal myocardium perfusion, but the long-term efficacy needs further assessment.
出处
《河北医药》
CAS
2008年第5期616-617,共2页
Hebei Medical Journal
关键词
急性心肌梗死
冠状动脉血栓形成
经皮冠状动脉介入治疗
血栓抽吸
acute myocardial infarction
intracoronary thrombosis
percutaneous coronary intervention
thrombus extraction
