CAJ | 학술논문

探讨血栓抽吸导管联合山莨菪碱在老年急性心肌梗死(AMI)患者介入治疗的可行性及临床疗效。方法邯郸市中心医院行急诊经皮冠状动脉介入治疗(PCI)的患者80例,随机分为两组,观察组(血栓抽吸导管联合山莨菪碱组)40例和对照组40例,观察术后校正的心肌梗死溶栓试验(TIMI)血流计帧数(CTFC)、TIMI心肌灌注分级(TMPG),术后1个月左心室舒张末内径(LVEDD)和左心室射血分数(LVEF),住院期间及术后1个月内主要不良心血管事件(MACE)发生率。结果与对照组比较,观察组术后CTFC明显减少(31.4±5.8)帧 vs (22.9±7.3)帧(P<0.05),术后 TMPG 3级比例增高(87.5% vs 62.5%,P <0.05)；观察组 LVEF 和 LVEDD 均好于对照组(58.62±7.13)% vs (45.38±5.28)%；(47.52±3.12)mm vs (57.56±2.68)mm(均P<0.05)；术后1个月观察组MACE发生率明显低于对照组(P<0.05)。结论应用血栓抽吸导管联合山莨菪碱可显著增加老年 AMI术后心肌组织灌注,改善心功能,减少不良心血管事件发生率。
탐토혈전추흡도관연합산랑탕감재노년급성심기경사(AMI)환자개입치료적가행성급림상료효。방법함단시중심의원행급진경피관상동맥개입치료(PCI)적환자80례,수궤분위량조,관찰조(혈전추흡도관연합산랑탕감조)40례화대조조40례,관찰술후교정적심기경사용전시험(TIMI)혈류계정수(CTFC)、TIMI심기관주분급(TMPG),술후1개월좌심실서장말내경(LVEDD)화좌심실사혈분수(LVEF),주원기간급술후1개월내주요불양심혈관사건(MACE)발생솔。결과여대조조비교,관찰조술후CTFC명현감소(31.4±5.8)정 vs (22.9±7.3)정(P<0.05),술후 TMPG 3급비례증고(87.5% vs 62.5%,P <0.05)；관찰조 LVEF 화 LVEDD 균호우대조조(58.62±7.13)% vs (45.38±5.28)%；(47.52±3.12)mm vs (57.56±2.68)mm(균P<0.05)；술후1개월관찰조MACE발생솔명현저우대조조(P<0.05)。결론응용혈전추흡도관연합산랑탕감가현저증가노년 AMI술후심기조직관주,개선심공능,감소불양심혈관사건발생솔。
Objective To investigate the feasibility and clinical efficacy of thrombus aspiration catheter combined with anisodamine in elderly patients with acute myocardial infarction(AMI)during percutaneous coronary intervention(PCI).Methods Eighty patients who underwent emergent PCI in Handan Central Hospital were randomly divided into two groups,the observation group (thrombus aspiration catheter combined with anisodamine group)40 cases and the control group 40 cases.Observation was performed on the corrected Thrombolysis in Myocardial Infarction trial(TIMI)flow frame count(CTFC),TIMI myocardial perfusion grade(TMPG),left ventricular end-diastolic diameter (LVEDD)and left ventricular ejection fraction (LVEF)one month after PCI,major adverse cardiovascular events(MACE)rate during hospitalization and one month after PCI.Results Compared with the control group,the value of CTFC in observation group was significantly less,(31.4±5.8)frame numbers vs (22.9±7.3) frame numbers(P<0.05),the proportion of TMPG3 was higher after PCI(87.5% vs 62.5%,P<0.05);LVEF and LVEDD in observation group were better than those in control group (58.62±7.13)% vs (45.38±5.28)%;(47.52± 3.12)mm vs (57.56±2.68)mm(bothP<0.05);MACE rate between two groups was no statistic significance during hospitalization(P >0.05);MACE rate in observation group was significantly lower compared with that in control group one month after PCI (P <0.05 ).Conclusion Thrombus aspiration catheter combined with anisodamine significantly increased myocardial tissue perfusion in elderly patients with AMI after PCI,improved heart function and reduced the incidence of adverse cardiovascular events.