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目的评价血栓抽吸治疗在急性心肌梗死(AMI)老年患者经皮冠状动脉介入治疗(PCI)中的疗效。方法回顾性分析2011年1月至2012年12月在我院行PCI术的AMI老年患者80例,其中单纯直接PCI术为对照组(n=40),直接PCI术联合血栓抽吸治疗为血栓抽吸组(n=40)。评估PCI术后TIMI血流分级、慢血流或无复流、PCI术后ST段回落率、术后肌酸激酶同工酶(CK-MB)和肌钙蛋白T(TnI)从发病到达峰值时间、术后1周和6个月左室射血分数(LVEF)、住院期间和PCI术后6个月内主要心脏不良事件(MACE)发生率。结果与对照组相比,血栓抽吸组PCI术后即刻TIMI3级比例(95.0%比75.0%,P<0.05),慢血流或无复流(5.0%比75.0%,P<0.05),ST回落率(65.3±7.9比42.1±10.8,P<0.05),术后CK-MB和TnT达峰时间均有提前,但差异无显著性。1周后LVEF(50.2±8.6比49.1±9.1,P>0.05),6个月后LVEF(54.1±3.2比49.6±8.3,P<0.05)。结论在老年AMI患者PCI中应用血栓抽吸治疗是有效的,能改善心肌灌注,提高LVEF,对预后产生积极疗效。
Objective To evaluate the efficacy of thrombus aspiration in percutaneous coronary intervention (PCI) in elderly patients with acute myocardial infarction (AMI). Methods A retrospective analysis of 80 elderly patients with AMI who underwent PCI in our hospital from January 2011 to December 2012 was performed. Direct PCI was used as the control group (n = 40). PCI was combined with thrombus aspiration for thrombus Suction group (n = 40). To assess TIMI flow classification, slow blood flow or no-reflow after PCI, ST-segment resolution after PCI, postoperative peak values of CK-MB and TnI Time, left ventricular ejection fraction (LVEF) at 1 week and 6 months after surgery, incidence of major adverse cardiac events (MACE) during hospitalization and 6 months after PCI. Results Compared with the control group, TIMI grade 3 (95.0% vs 75.0%, P <0.05), slow or no reflow (5.0% vs 75.0%, P <0.05) (65.3 ± 7.9 vs 42.1 ± 10.8, P <0.05). The peak time of CK-MB and TnT after operation was earlier than that of control group, but the difference was not significant. After 1 week, LVEF (50.2 ± 8.6 vs 49.1 ± 9.1, P> 0.05) and LVEF after 6 months (54.1 ± 3.2 vs 49.6 ± 8.3, P <0.05). Conclusion The application of thrombus aspiration in elderly PCI patients with AMI is effective, which can improve myocardial perfusion, improve LVEF and have a positive effect on prognosis.