论文部分内容阅读
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 evaluate the efficacy and safety of DiverCE aspiration catheter in percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) with large thrombus load. Methods Thirty patients with acute myocardial infarction (AMI) who underwent emergency coronary angiography (CEA) indicated that thrombus was heavily loaded in patients with AMI. Diverce thrombectomy catheter was used to aspirate the infarct-related intravascular thrombus during the interventional treatment. The thrombus load and blood flow before and after the aspiration were observed. Twenty-eight AMI patients underwent conventional emergency PCI as control group. Results Coronary angiography showed significant thrombus signs in all 30 patients in DiverCE + PCI group. The load of infarction-related vascular thrombosis was significantly reduced after aspiration, TIMI grade and TMP grade in blood flow were significantly improved compared with those in PCI group (all P <0.05) CK and CK-MB peaked lower, ST-segment decline amplitude was larger, LVEF higher than that of control group (P <0.05), left ventricular end-diastolic diameter Less than the control group (all P <0.05). Conclusion Compared with conventional PCI, it is safe and feasible to use DiverCE thrombus aspiration catheter in AMI patients with severe thrombus load, which can effectively reduce the infarction-related intravascular thrombus load in AMI patients and significantly improve the immediate distal myocardial blood flow Perfusion, but the long-term efficacy needs further evaluation.