论文部分内容阅读
目的评价在急性冠状动脉综合征(ACS)急诊介入治疗中应用Diver C.E.血栓抽吸器的安全性和有效性。方法2005年7月~2006年9月,共70例接受急诊经皮冠状动脉介入治疗(PCI)的ACS患者纳入研究,其中抽吸器组35例,根据冠状动脉造影及临床情况从同期急诊介入治疗的ACS患者中选取35例条件相匹配者作为对照组。比较两组间的基础资料、造影结果和临床预后。结果抽吸器组支架直接置入率高(P=0.009),远端栓塞发生率低(P=0.046),校正的心肌梗死溶栓试验帧数计数值小(P=0.004),心肌灌注分级3级获得率高(P=0.044);急性ST段抬高型心肌梗死中抽吸器组术后肌酸激酶同工酶和肌钙蛋白T峰值浓度较低,ST段回落幅度大,均明显优于对照组(P<0.05),但两组住院期间和中期随访主要心血管事件发生率差异无显著性意义。结论在血栓负荷较重的ACS患者中,急诊PCI时应用Diver C.E.血栓抽吸器安全可行,可显著改善患者术后即刻的远端心肌血流微灌注,减少心肌酶的释放,但远期疗效还需进一步评价。
Objective To evaluate the safety and efficacy of Diver C.E. thrombus aspiration in the emergency treatment of acute coronary syndrome (ACS). Methods From July 2005 to September 2006, a total of 70 ACS patients undergoing emergency percutaneous coronary intervention (PCI) were enrolled in this study. Among them, 35 patients undergoing aspiration were enrolled from the same period of emergency according to coronary angiography and clinical conditions 35 cases of ACS patients treated with matching conditions as a control group. Baseline data, radiographic findings and clinical outcomes were compared between the two groups. Results Aspiration rate was significantly higher in the aspiration group (P = 0.009), lower incidence of distal embolization (P = 0.046), corrected myocardial infarction thrombolysis (P = 0.004) (P = 0.044). The peak concentrations of creatine kinase and troponin T in the aspirator group were lower than those in the ST-segment elevation acute myocardial infarction (P <0.05). However, there was no significant difference in the incidence of major cardiovascular events between the two groups during hospitalization and in the mid-term follow-up. Conclusions In patients with severe thrombus overload ACS, Diver CE thrombus aspiration device is safe and feasible in emergency PCI, which can significantly improve the microvascular perfusion of distal myocardial immediately after operation and reduce the release of myocardial enzymes, but the long-term efficacy Need further evaluation.