张奇,张瑞岩,胡健,杨震坤,丁风华,朱政斌,杜润,朱天奇,张建盛,沈卫峰

• 1:上海交通大学医学院附属瑞金医院心脏科

摘要(Abstract)：

目的探讨直接经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术前应用血栓抽吸处理是否有助于改善支架置入后球囊后扩张(post-stenting balloon dilation,PSBD)后的冠状动脉血流程度。方法回顾性分析814例接受直接PCI的ST段抬高急性心肌梗死患者资料,入选接受PSBD的患者146例。根据支架置入前是否进行血栓抽吸操作分为抽吸组(57例)和对照组(89例)。比较两组的基线特征、冠状动脉病变及介入治疗情况、术后即刻冠状动脉TIMI血流、心肌灌注分级(myocardial blush grade,MBG)及90 min时心电图ST段回落程度。结果两组患者基线资料及冠状动脉造影结果比较,差异均无统计学意义。抽吸组术后即刻TIMI血流Ⅲ级(73.7%比60.7%)和MBG分级Ⅲ级(49.1%比47.2%)获得率高于对照组,但差异均无统计学意义(均P>0.05)。术后90 min两组心电图ST段回落程度(ST-segment resolution,STR)≥70%获得率比较,差异无统计学意义(47.4%比41.6%,P=0.49)。两组术后30 d无主要不良心脏事件生存率比较,差异无统计学意义(93.0%比89.9%,P=0.51)。结论急性心肌梗死直接PCI患者血栓抽吸并未改善PSBD后冠状动脉血流及30 d临床预后,对于急诊PSBD,仍需寻找其他方法以期改善术后即刻血流。

关键词(KeyWords)： 心肌梗死;支架;后扩张;血栓抽吸;心肌灌注

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金面上项目(81470392)

作者(Author): 张奇,张瑞岩,胡健,杨震坤,丁风华,朱政斌,杜润,朱天奇,张建盛,沈卫峰

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