远端保护装置AngioguardTM在急性心肌梗死急诊经皮冠状动脉介入治疗中的应用The application of AngioguardTM distal protection device in the emergency percutaneous coronary intervention in patients with acute ST segment elevation myocardial infarction
王乐丰,杨新春,佟子川,徐立,吴兆苏,张维君,王红石,邹阳春,葛永贵,王立中,李惟铭,周旭,连勇,栾与英
摘要(Abstract)：
目的 评价STEMI急诊PCI中应用AngioguardTMDPD的疗效和安全性。方法 自 2 0 0 2年 7月至 12月 ,共 4 0例接受急诊PCI治疗的STEMI患者纳入研究 ,其中AngioguardTMDPD组 2 1例 ,对照组 19例。比较两组间的基础临床状况、造影情况、介入治疗结果以及住院期间随访情况 ,病变血管术后均行TIMI分级、TIMI计帧和心肌Blush分级。结果 AngioguardTM DPD组中 ,19例获得成功(90 4 % ) ,网篮内均有多少不等的血栓样物质。两组间的基础临床状况、术前造影情况和术后TIMI3级 (10 0 %和 84 % ,P =0 2 3)差异均无显著性。但DPD组与对照组间发生远端小血管栓塞为 (5 2 %和36 8% ,P =0 0 4 2 ) ;两组的TIMI帧数为 (19 9± 5 7和 30 3± 9 6 ,P <0 0 0 1) ;Blush 3级获得率为(73 7%和 31 6 % ,P =0 0 2 2 )。DPD组术后CK峰值浓度较低 ,ST段回落幅度大 ,近期左室射血分数高 ,均优于对照组 (P <0 0 5 )。两组住院期间均无主要心血管事件发生。结论 在某些STEMI病人中 ,急诊PCI时应用AngioguardTM DPD安全可行 ,可改善患者术后的远端心肌血流灌注 ,提高患者的心功能。应用TIMI计帧法和Blush分级法优于应用TIMI分级法。
关键词(KeyWords)： 急性心肌梗死;血管成形术,经皮,经腔冠状动脉;AngioguardTM远端保护装置
基金项目(Foundation):
作者(Author): 王乐丰,杨新春,佟子川,徐立,吴兆苏,张维君,王红石,邹阳春,葛永贵,王立中,李惟铭,周旭,连勇,栾与英
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