抽吸导管联合硝普钠在急性心肌梗死介入治疗中的作用

徐晓辉; 武卫党; 王聪霞; 路 艳; 丁法明

抽吸导管联合硝普钠在急性心肌梗死介入治疗中的作用

Effect of aspiration catheter and sodium nitroprusside on treatment for patients with acute myocardial infarction treated by primary percutaneous coronary intervention

摘要

摘要: 目的:探讨在急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入（PCI）治疗中应用抽吸导管联合冠脉内注射硝普钠对改善心肌组织灌注及预后的影响。方法:146例于我院行急诊PCI的STEMI患者，分为常规PCI组（常规治疗组）、抽吸导管组（导管抽吸组）、抽吸导管联合硝普钠组（联合措施组），比较3组术后TIMI血流恢复情况及术后30 d主要不良心血管事件(major adverse cardiac events,MACE)的发生率。结果:单纯使用抽吸导管组及抽吸导管联合硝普钠组与常规PCI组相比均能明显改善STEMI患者术后TIMI血流及预后（P<0.05），抽吸导管联合硝普钠组与单纯抽吸导管组相比能进一步改善STEMI患者术后TIMI血流（P<0.05）,且能明显减少术后MACE事件的发生率。结论:抽吸导管联合硝普钠可进一步改善心肌梗死患者冠脉血流状态，同时有可降低术后MACE发生率的趋势，尚须大样本证实。

Abstract: AIM:To investigate the effects of aspiration catheter and sodium nitroprusside on myocardial reperfusion for treatment of patients with acute STelevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PCI). METHODS: One hundred and fortysix patients with STEMI who underwent primary PCI were divided into three groups: 56 patients routinely treated without aspiration catheter (control group), 44 patients treated with aspiration catheter (group A), and 46 patients treated with aspiration catheter and sodium nitroprusside (group B). Patients were followedup prospectively for the incidence of major adverse cardiac events (MACE) including death, reinfarction and revascularization. RESULTS: The slowreflow phenomenon and MACE were much less in both group A and group B, especially in group B (P<005). CONCLUSION: Application of aspiration catheter and sodium nitroprusside improves coronary flow and lowers the incidence of MACE.

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