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目的评价急性ST段抬高心肌梗死(STEMI)患者急诊冠状动脉介入治疗(PCI)中应用DiverCE血栓抽吸装置的效果与安全性。方法选择抚顺市中心医院2006年7月至2007年6月接受直接PCI的STEMI患者46例,分成血栓抽吸组与直接PCI组,比较两组间2h胸痛缓解率、ST段回落率、TIMI3级血流、肌酸磷酸激酶(CK)及其同功酶(CK-MB)峰值、左室射血分数(LVEF)及术后1个月内心脏不良事件发生率。结果血栓抽吸组的2h胸痛缓解率、ST段回落率、TIMI3级血流、CK及CK-MB峰值、LVEF值明显优于直接PCI组(P<0.05),术后1个月内心脏不良事件发生率两组差异无显著性意义(P>0.05)。结论PCI中应用DiverCE血栓抽吸装置能明显减少冠状动脉血栓及远端栓塞,有效地改善心肌灌注。
Objective To evaluate the efficacy and safety of DiverCE thrombus aspiration in patients undergoing acute coronary intervention (PCI) with acute ST-segment elevation myocardial infarction (STEMI). Methods Forty-six STEMI patients undergoing direct PCI between July 2006 and June 2007 in Fushun Central Hospital were divided into thrombus aspiration group and direct PCI group. The 2-h chest pain relief rate, ST-segment drop rate, TIMI3 grade Blood flow, peak of creatine phosphokinase (CK) and its isoenzyme (CK-MB), left ventricular ejection fraction (LVEF) and the incidence of adverse cardiac events within 1 month after operation. Results The rate of chest pain relief, ST segment regression, TIMI grade 3 blood flow, CK and CK-MB peak and LVEF in thrombus aspiration group were significantly better than those in direct PCI group (P <0.05) There was no significant difference between the two groups (P> 0.05). Conclusion The application of DiverCE thrombus aspiration device in PCI can significantly reduce coronary thrombosis and distal embolization, effectively improve myocardial perfusion.