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目的:探讨应用远端保护装置GuardWire PlusTM治疗老年急性ST段抬高型心肌梗死(STEMI)对外周血肌钙蛋白(cTnI)、肌酸激酶同工酶(CK-MB)的影响。方法:将2004年9月至2009年12月在我院行急诊PCI的60例年龄>60岁老年STEMI患者分为远端保护组(GW)和非远端保护组(NGW)。于术前、术后4h、8h、12h、16h、24h、2d、3d、5d分别测定外周血cTnI、CK-MB水平,并比较两组间变化及其峰值水平。结果:两组全部病例均成功植入支架。GW组全部成功放置GuardWire PlusTM远端保护装置。发病后12h两组CK-MB的值有明显差别(P<0.05),并且GW组出现酶峰提前,发病后6h、12h两组的CTNI的值有明显差别(P<0.05),并且GW组出现峰值提前。结论:老年心肌梗死急诊PCI中应用远端保护装置可以缩小梗死面积,改善预后。
Objective: To investigate the effect of GuardWire PlusTM distal protective device on cTnI and CK-MB in elderly patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: From September 2004 to December 2009, 60 elderly STEMI patients aged> 60 years with acute PCI in our hospital were divided into distal protection group (GW) and non-distal protection group (NGW). The levels of cTnI and CK-MB in peripheral blood were measured before operation, at 4h, 8h, 12h, 16h, 24h, 2d, 3d and 5d after operation, and the changes and peak levels were compared between the two groups. Results: All cases were successfully implanted into the stent in both groups. GW Group all successfully placed GuardWire PlusTM remote protection device. There was a significant difference in CK-MB between the two groups at 12h after onset (P <0.05), and the peak of enzyme appeared in advance in GW group. There was a significant difference (P <0.05) in CTNI between the two groups at 6h and 12h after GW onset The peak appears ahead of time. Conclusion: The application of distal protection device in elderly patients with acute myocardial infarction can reduce infarct size and improve prognosis.