Diver CE血栓抽吸导管在急性心肌梗死恢复期患者介入术中的应用The appilication of diver CE thrombus aspiration catheter in patients during the recovery of acute myocardial infarction with percutaneous coronary intervention
牛和平,张军,袁琛,付金国,费玲,万艳芳,王长厚
摘要(Abstract):
目的评价Diver CE血栓抽吸导管在急性心肌梗死(AMI)恢复期介入过程中的效果。方法选择2010年1月至2011年12月间AMI恢复期血栓负荷较重患者共50例,随机分为两组,应用Diver CE血栓抽吸导管的血栓抽吸组和不应用Diver CE血栓抽吸导管的常规经皮冠状动脉介入治疗(PCI)组。比较两组患者基础资料、PCI相关情况及临床预后等。结果两组患者基础临床资料差异无统计学意义(P>0.05);术后血栓抽吸组血栓积分(TS)、心肌呈色分级(MBG)3级获得率、无复流及慢血流发生率低于常规对照组(P<0.05);血栓抽吸组术后6个月、12个月左心室射血分数(LVEF)均高于常规对照组(P<0.05);住院期间和术后随访期间主要不良心血管事件(MACE)发生率两组比较差异无统计学意义。结论在对血栓负荷较重的AMI恢复期患者行PCI的过程中,应用Diver CE血栓抽吸导管是安全、有效的一种方法。
关键词(KeyWords): 急性心肌梗死;抽吸导管;经皮冠状动脉介入治疗
基金项目(Foundation): 河北省医学适用技术跟踪项目(GL200911)
作者(Author): 牛和平,张军,袁琛,付金国,费玲,万艳芳,王长厚
参考文献(References):
- [1]Burzotta F,De Vita M,Gu YL,et al.Clinical impact of thrombectomy in acute ST-elevation myocardial infarction;an individual patient-data pooled analysis of 11 trials.Eur Heart J,2009,30:2193-2203.
- [2]李伟,卢明瑜,王伟民,等.血栓抽吸导管在急性心肌梗死恢复期择期经皮冠状动脉介入治疗中应用的临床研究.中国循环杂志,2010,165:332-335.
- [3]Ito H.No-refl ow phenomenon and prognosis in patients with acute myocardial infarction.Nat Clin Pract Cardiovasc Med,2006,3:499–506.
- [4]Iwakura K.Modulation of individual susceptibility to the no-refl ow phenomenon after acute myocardial infarction.Curr Pharm Des,2013,19:4519-4528.
- [5]Kastrati A,Byrne RA,Sch?mig A,et al.Is it time to jettison complex mechanical thrombectomy in favor of simple manual aspiration devices?J Am Coll Cardiol,2010,56:1307-1309.
- [6]Abbate A,Biondi-Zoccai GG,Appleton DL,et al.Survival and cardiac remodeling benefi ts in patients undergoing late percutaneous coronary intervention of the infarct-related artery:evidence from a meta-analysis of randomized controlled trials.J Am Coll Cardiol,2008,51:956-964.
- [7]Kruk M,Buller CE,Tcheng JE,et al.Impact of left ventricular ejection fraction on clinical outcomes over fi ve years after infarctrelated coronary artery recanalization(from the Occluded Artery Trial[OAT]).Am J Cardiol,2010,105:10-16.
- [8]杨延宗,王旭,邵兵,等.血栓抽吸治疗急性ST段抬高心肌梗死前后神经内分泌因子水平的变化.中国介入心脏病学杂志,2008,2:77-81.
- [9]Tamura A,Shinozaki K,Watanabe T,et al.Effect of preinfarction angina pectoris on myocardial blush grade after reperfusion in fi rst anterior wall acute myocardial infarction.Circ J,2006,70:698-702.
- [10]赵汉军,颜红兵,李狄,等.急性心肌梗死冠状动脉内抽吸物的病理分析.中华心血管病杂志,2009,37:785-789.