CAJ | 학술논문

急性心肌梗死急诊心脏介入治疗时发生的无复流或慢血流可影响治疗效果和临床预后，其中主要的机制是血栓栓塞。从理论上讲血栓抽吸应是有效的处理措施。近年来大量的临床试验证实血栓抽吸不仅可有效地使梗死相关动脉再通，并使冠状动脉微循环保持通畅，降低无复流和慢血流的发生率。最近临床研究表明血栓抽吸可减轻病变心肌的炎症反应，改善微循环功能，联合溶栓抗栓药物可减少血栓负荷，改善冠状动脉的血流灌注，减少梗死面积，抑制心室重塑，改善心功能，降低近期和远期主要不良心脏事件的发生率，降低晚期支架再狭窄的发生率并减少出血并发症，从而改善预后。
급성심기경사급진심장개입치료시발생적무복류혹만혈류가영향치료효과화림상예후，기중주요적궤제시혈전전새。종이론상강혈전추흡응시유효적처리조시。근년래대량적림상시험증실혈전추흡불부가유효지사경사상관동맥재통，병사관상동맥미순배보지통창，강저무복류화만혈류적발생솔。최근림상연구표명혈전추흡가감경병변심기적염증반응，개선미순배공능，연합용전항전약물가감소혈전부하，개선관상동맥적혈류관주，감소경사면적，억제심실중소，개선심공능，강저근기화원기주요불양심장사건적발생솔，강저만기지가재협착적발생솔병감소출혈병발증，종이개선예후。
The no reflow or slow reflow following emergency percutaneous coronary intervention can affect clinical outcome and prognosis of the patients with acute myocardial infarction ,the main mechanism of which is thrombus embolism.In theory,thrombus aspiration(TA) should be the effective approach.In recent years,the results of many clinical trials about TA have showed that it not only can make infarction-related artery(IRA)reopen,but also maintain microcirculatory patency of IRA,reduce the occurrences of no reflow or slow reflow.Recently, clinical studies proved that TA combined thrombolytic medicines and anti-platelet drugs with alternatives lessening thrombus burden can greatly improve reflow of IRA ,decrease infarction size, inhibit myocardial remodeling,improve cardiac function,lower rates of recent and long-term major adverse cardiac events,reduce inflammation of lesion myocardium,decrease occurrences of in-stent restenosis and major bleeding complication,which consequently can improve the prognosis of acute myocardial infarction.