中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2012年
11期
4-6
,共3页
ST段抬高的心肌梗死%急诊经皮冠状动脉介入治疗%血栓抽吸%心功能
ST段抬高的心肌梗死%急診經皮冠狀動脈介入治療%血栓抽吸%心功能
ST단태고적심기경사%급진경피관상동맥개입치료%혈전추흡%심공능
ST segment elevation myocardial infarction (STEMI)%Emergency percutaneous coronary intervention%Thrombus-aspiration%Cardiac function
目的 评价急诊经皮冠状动脉介入(PCI)术联合血栓抽吸治疗对急性ST段抬高型心肌梗死(STEMI)患者心室重构、心功能的近期及远期影响.方法 选择2008年5月至2011年5月急诊PCI治疗的STEMI患者250例,其中急诊PCI术加血栓抽吸治疗者为血栓抽吸组132例；同时期条件相当仅行急诊PCI治疗患者作为标准PCI组118例.比较两组的基础资料、术后及住院和随访期间等情况.结果 血栓抽吸组支架直接置入率、术后2h ST段回落＞50％率、TIMI 3级血流均明显优于标准PCI组；发病后24h肌酸激酶同工酶值、心肌肌钙蛋白Ⅰ与N端前脑钠肽素值显著低于标准PCI组,术后30d、90d和180d室舒张末期内径、左室收缩末期内径、左室射血分数明显改善；术后30d、90d和180d主要不良心血管事件明显减少.结论 STEMI急诊介入术中血栓抽吸治疗安全可靠,可以增加心肌水平的血流灌注,减少坏死心肌数量,提高患者的心功能,减少不良心血管事件的发生,改善预后.
目的 評價急診經皮冠狀動脈介入(PCI)術聯閤血栓抽吸治療對急性ST段抬高型心肌梗死(STEMI)患者心室重構、心功能的近期及遠期影響.方法 選擇2008年5月至2011年5月急診PCI治療的STEMI患者250例,其中急診PCI術加血栓抽吸治療者為血栓抽吸組132例；同時期條件相噹僅行急診PCI治療患者作為標準PCI組118例.比較兩組的基礎資料、術後及住院和隨訪期間等情況.結果 血栓抽吸組支架直接置入率、術後2h ST段迴落＞50％率、TIMI 3級血流均明顯優于標準PCI組；髮病後24h肌痠激酶同工酶值、心肌肌鈣蛋白Ⅰ與N耑前腦鈉肽素值顯著低于標準PCI組,術後30d、90d和180d室舒張末期內徑、左室收縮末期內徑、左室射血分數明顯改善；術後30d、90d和180d主要不良心血管事件明顯減少.結論 STEMI急診介入術中血栓抽吸治療安全可靠,可以增加心肌水平的血流灌註,減少壞死心肌數量,提高患者的心功能,減少不良心血管事件的髮生,改善預後.
목적 평개급진경피관상동맥개입(PCI)술연합혈전추흡치료대급성ST단태고형심기경사(STEMI)환자심실중구、심공능적근기급원기영향.방법 선택2008년5월지2011년5월급진PCI치료적STEMI환자250례,기중급진PCI술가혈전추흡치료자위혈전추흡조132례；동시기조건상당부행급진PCI치료환자작위표준PCI조118례.비교량조적기출자료、술후급주원화수방기간등정황.결과 혈전추흡조지가직접치입솔、술후2h ST단회락＞50％솔、TIMI 3급혈류균명현우우표준PCI조；발병후24h기산격매동공매치、심기기개단백Ⅰ여N단전뇌납태소치현저저우표준PCI조,술후30d、90d화180d실서장말기내경、좌실수축말기내경、좌실사혈분수명현개선；술후30d、90d화180d주요불양심혈관사건명현감소.결론 STEMI급진개입술중혈전추흡치료안전가고,가이증가심기수평적혈류관주,감소배사심기수량,제고환자적심공능,감소불양심혈관사건적발생,개선예후.
Objective To evaluate the long-term and short-term effects of thrombus-aspiration combined with emergency percutaneous coronary intervention (PCI)on the left ventricular remodeling and cardiac function of patients with acute ST segment elevation myocardial infarction(STEMI).Methods Two hundred and fifty patients with STEMI underwent emergent PCI from Mar 2008 to Mar 2011 were selected.Among them,132 patients received emergency PCI combined with thrombus-aspiration were enrolled in thrombus aspiration group,and the other 118 patients who only received emergency PCI were enrolled in control group.The clinical data,information after operation and the follow-up data were compared between the two groups.Results Compared with the control group,thrombus aspiration group had more direct stent and faster ST segment resolution rates,improved grade3 of TIMI,lower serum CK-MB,eTnI and NT-proBNP levels.The diffierences in LVEDD,LVESD,LVEF,MACE between the two groups were significant.Conclusions Thrombus-aspiration combined with emergency PCI is safe and effective,and can improve the myocardium blood perfusion,cardiac function,reduce middle and late cardiovascular events,improve the prognosis.
