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目的:分析在急性ST段抬高型心肌梗死(STEMI)急诊行经皮冠状动脉介入治疗(PCI)中应用抽吸导管对心肌再灌注影响。方法:首次STEMI行PCI患者80例,随机分为试验组(41例,应用抽吸导管后再行PCI),对照组(39例,直接行PCI)。比较2组术后即刻计算校正TIMI计帧数和心肌Blush分级、术中慢复流现象、心电图90minST段下降率。在术后24h、1周时应用心肌声学造影计算灌注对比积分指数(CSI)、室壁运动积分指数(WMSI)。结果:PCI后试验组的校正TIMI计帧数明显低于对照组,Blush分级≥2级获得率高于对照组,慢复流现象减少;再通后90min心电图相关导联ST段下降率试验组明显大于对照组(P<0.05)。同时在研究的每一个时点,试验组CSI、WMSI较对照组明显降低(P<0.05)。结论:在STEMI急诊行PCI中应用抽吸导管可改善梗死相关血管前向血流情况,改善心肌再灌注,减少无复流现象。
Objective: To analyze the effect of aspiration catheter on myocardial reperfusion in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). Methods: The first 80 STEMI patients were randomly divided into experimental group (41 cases, PCI with suction catheter) and control group (39 cases with PCI). The TIMI frame count and myocardial Blush grading, intraoperative slow reflow phenomenon and the decline rate of electrocardiogram (90minST) were compared between the two groups immediately after operation. At 24 hours and 1 week after operation, myocardial contrast weighted index (CSI) and wall motion integral index (WMSI) were calculated by myocardial contrast echocardiography. Results: After PCI, the number of corrected TIMI frames in the experimental group was significantly lower than that in the control group. The Blush grade ≥2 level acquisition rate was higher than that in the control group, and the slow reflow phenomenon was reduced. Significantly higher than the control group (P <0.05). At the same time, CSI and WMSI in the experimental group were significantly lower than those in the control group at each time point (P <0.05). CONCLUSIONS: The use of aspiration catheters in STEMI emergency PCI can improve infarct-related blood flow, improve myocardial reperfusion and reduce no-reflow phenomenon.