CAJ | 학술논문

目的：评价血栓抽吸在急性右冠脉闭塞心肌梗死介入治疗中的临床效果和安全性。方法：将2010年1月至2014年12月南方医科大学附属南海人民医院收治的108例老年右冠脉单支近中段闭影次全闭塞患者随机分为两组：对照组（52例）予冠脉内注射替罗非班后直接置入支架，观察组（56例）予冠脉内注射替罗非班＋血栓抽吸后置入支架。比较两组治疗后即刻 TIMl 血流、TMP、危险心肌抢救指数、术后30 d 左室射血分数、30 d 内主要心血管事件发生率等指标。结果：与对照组比较，观察组术后 TIMl 血流0~1级发生率低，TIMl 血流3级和 TMP 3级比例较高，危险心肌抢救指数及术后30 d 左室射血分数提高，术后30 d 内主要心血管事件发生率低（均 P﹤0.05）。结论：老年急性右冠闭塞心肌梗死介入治疗中应用支架联合血栓抽吸是安全、有效的方法。
목적：평개혈전추흡재급성우관맥폐새심기경사개입치료중적림상효과화안전성。방법：장2010년1월지2014년12월남방의과대학부속남해인민의원수치적108례노년우관맥단지근중단폐영차전폐새환자수궤분위량조：대조조（52례）여관맥내주사체라비반후직접치입지가，관찰조（56례）여관맥내주사체라비반＋혈전추흡후치입지가。비교량조치료후즉각 TIMl 혈류、TMP、위험심기창구지수、술후30 d 좌실사혈분수、30 d 내주요심혈관사건발생솔등지표。결과：여대조조비교，관찰조술후 TIMl 혈류0~1급발생솔저，TIMl 혈류3급화 TMP 3급비례교고，위험심기창구지수급술후30 d 좌실사혈분수제고，술후30 d 내주요심혈관사건발생솔저（균 P﹤0.05）。결론：노년급성우관폐새심기경사개입치료중응용지가연합혈전추흡시안전、유효적방법。
Objective:To evaluate the clinical effect and safety of thrombus aspiration on acute right coronary occlusion,myocardial infarction in interventional therapy. Methods:A total of 108 elderly patients with total occlusion at proximal - middle segment of single right coronary artery,who were hospitalized in Nanhai Municipal Peopleˊs Hospital Affiliated to Southern Medical University between January 2010 and December 2014, were randomly divided into two groups:the control group(n= 52)was given Tirofiban by intracoronary injection and underwent the placement of coronary stent directly;the study group( n = 56)was given Tirofiban by intracoronary injection + thrombus aspiration,and underwent the placement of coronary stent. The immediate TIMl blood flow after percutaneous coronary intervention,TMP,risk index of myocardial salvage,left ventricular ejection fraction(LVEF)at 30 d after the operation,incidence of major adverse cardiovascular events(MACE)at 30d after the operation between the two groups were compared. Results:Compared with the control group,low incidence of postoperative TIMl blood flow(level 0~1),high ratio of level 3 TIMl blood flow and level 3 TMP, increased risk index of myocardial salvage and LVEF at 30 d after the operation,low incidence of MACE at 30 d after the operation were found in the study group(P﹤0.05). Conclusion:The application of thrombus aspiration on elderly acute right coronary occlusion,myocardial infarction in interventional therapy is a safe and effective method.