李玉耕+++++林红丽

[摘要] 目的 探讨血栓抽吸对急性ST段抬高型心肌梗死（STEMI）患者预后的影响。方法 对该院2010年5月—2012年5月期间收治的行PCI、同时给予血栓抽吸治疗的65例急性STEMI患者的临床资料进行回顾性分析，将其作为观察组，选择同期行直接PCI的65例急性STEMI患者作为对照组，比较两组患者的近远期预后。结果 在TIMI 3级、ST段回落50%、再灌注心律失常等近期预后指标上，观察组患者明显优于对照组患者，差异有统计学意义（P<0.05）；在再住院率、死亡率、LVEF>50%例数等远期预后指标上，两组患者无明显差别，差异无统计学意义（P>0.05）；实验组患者的LVEF>50%例数明显高于对照组患者，差异有统计学意义（P<0.05）。结论 在给予急性STEMI患者行PCI的同时给予血栓抽吸治疗，能够改善患者的近期预后，但是对再住院率、死亡率、LVEF值等远期预后的影响较小，有着重要的临床参考意义。

[关键词] 急性心梗；ST段抬高；血栓抽吸装置；预后

[中图分类号] R542.22 [文献标识码] A [文章编号] 1674-0742（2015）01（b）-0084-02

Impact of thrombectomy device for acute ST-segment elevation myocardial infarction prognosis

LI Yugen1 LIN Hongli2

1.The 4th Haici medical Group cardiovascular Division Two， Qingdao City， Shandong Province， 266033，China；2.Qingdao Haici Department of Health Care Medical Group cadres，Qingdao City，Shangdong Province， 266033，China

[Abstract] Objective To investigate the effects of thrombus aspiration on the prognosis of patients with acute ST-segment elevation myocardial infarction. Methods Analyzed retrospectively 65 cases of direct PCI for acute ST-segment elevation myocardial infarction in our hospital from May 2010 - May 2012 undergoing PCI thrombus aspiration treatment while giving the clinical data of patients， took these 65 cases as observation group， then chose 65 cases of direct PCI for acute ST-segment elevation myocardial infarction patients in the same period as a control group， compare short term and long term prognosis of patients. Results In TIMI3 level， ST segment fell 50 percent， on reperfusion arrhythmias and other indicators of prognosis， patients in observation group were significantly better than control group， the differences were statistically significant （P <0.05）； in the readmission rates， mortality， on LVEF> 50% the number of cases and other long-term prognosis， there was no significant difference between patients in the two groups， the difference was not statistically significant （P> 0.05）；on LVEF> 50% the number of cases， patients in observation group were significantly better than control group， the differences were statistically significant （P <0.05）. Conclusions In patients with acute ST segment， can improve patient's short - term prognosis， but has little effect on long-term prognosis readmission rates， mortality， LVEF values， etc.，the reference has important clinical significance.

[Key words] Acute myocardial infarction； ST segment elevation； Thrombectomy device； Prognosis

随着人们生活的改善，急性心梗的发病率逐年升高，严重威胁着患者的生命和健康，PCI作为急性心梗的首选治疗方案，能够将梗死相关动脉尽早开通，对救治患者发挥着巨大的作用，但有研究指出，PCI时会出现斑块的脱落、血管痉挛和血栓负荷，在术后梗死相关动脉容易出现慢复流或者无复流的现象，影响患者的预后。血栓抽吸装置属于远端栓塞防护装置，能减少心血管事件的发生，改善患者预后[1]。该研究对2010年5月—2012年5月期间，该院收治的65例行PCI的急性STEMI患者，在行PCI治疗的同时给予血栓抽吸治疗，取得了较为理想的治疗效果，现报道如下。endprint

1 资料与方法

1.1 一般资料

两组研究对象均来源于在该院住院的确诊为急性STEMI的患者，上述患者的心电图符合2个或以上相邻的胸导联ST段升高超过0.2 mV，或者肢体导联ST段升高超过0.1 mV的表现；上述患者……