要英杰,王旭,邵一兵,王正忠,王燕,杨延民,张纯全

• 1: 青岛市市立医院东院区心内科
• 2:青岛市市立医院东院区心内科
• 3:青岛市市立医院东院区心内科
• 4:青岛市市立医院东院区心内科

摘要(Abstract)：

目的评价在急性心肌梗死(AMI)急诊经皮冠状动脉介入治疗(PCI)过程中,应用远端保护装置GuardWire PlusTM的安全性及有效性。方法自2004年9月至2006年5月共72例AMI接受急诊PCI治疗的患者分为远端保护组(GW组)和非远端保护组(NGW组),其中GW组38例,NGW组34例。比较两组间的基础临床状况、造影情况、ST段回落情况、肌酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)的峰值变化、术后1周内及3个月后左室射血分数(LVEF)。结果两组全部病例均成功地置入支架。GW组全部成功放置GuardWire PlusTM保护装置。GW组ST段回落50%的百分比明显高于NGW组(68·4%比41·2%,P<0·05)。GW组CK-MB高峰于发病后8·63±2·42h出现,NGW组的高峰出现在发病后11·18±2·26h,GW组峰值低于NGW组(63·30±9·82ng/mL比74·28±6·15ng/mL,P=0·000)。GW组CTnI高峰于发病后10·16±2·96h出现,NGW组的高峰值出现于发病后12·35±2·06h,两组高峰值有明显差别,GW组低于NGW组(18·01±7·21ng/mL比21·48±5·61ng/mL,P=0·027)。GW组的LVEF明显高于NGW组。结论急性心肌梗死急诊PCI中联合应用远端保护装置可以有效的预防远端血栓栓塞,缩小梗死面积,改善LVEF。

关键词(KeyWords)： 心肌梗死;血栓栓塞;远端保护装置;肌酸激酶,MB型;肌钙蛋白I

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 要英杰,王旭,邵一兵,王正忠,王燕,杨延民,张纯全

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