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急性心肌梗死 PCI中Percusurge 远端保护装置对P-选择素和纤溶活性的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2006年第4期
页码:
432-435
栏目:
临床研究
出版日期:
2006-08-25

文章信息/Info

Title:
Influences of Percusurge distal protection device on the level of plasma P-selection,tissue type plasminogen activator,plasminogen activator inhibitor-1 in coronary intervention in acute myocardial infarction
作者:
郭瑄; 李成祥; 王海昌; 贾国良; 曹丰; 冯旭阳; 高延
第四军医大学西京医院心脏内科，陕西 西安 710032
Author(s):
GUO Xuan; LI Cheng-xiang; WANG Hai-chang;  JIA Guo-liang;  CAO Feng; FENG Xu-yang;  GAO Yan
Department of Cardiology, Xijing Hospital, Fouth Military Medical University,Xi′an,Shaanxi 710032
关键词:
血管成形术; 心肌梗塞; Percusurge远端保护装置; P-选择素; 纤溶酶原激活剂; 纤溶酶原激活剂抑制物-1
Keywords:
percutaneous coronary intervention;  myocardial infarction;  Percusurge guardwire distal protection system;  Pselection;  tissuetype plasminogen activator;  plasminogen activator inhibitor1
分类号:
R542.22
DOI:
-
文献标识码:
A
摘要:
目的 探讨Percusurge远端保护装置（DPD）在急性心肌梗死（AMI） PCI中对P-选择素(Ps)、纤溶酶原激活剂(tPA)、 纤溶酶原激活剂抑制物1(PAI1) 的影响及作用机制。方法 接受急诊PCI治疗的AMI患者72例， DPD组39例,对照组33例， 经股静脉将6F右冠状动脉造影导管置入冠状静脉窦于PTCA前、 DPD后即刻、0.5、 2、6 h采血分别检测血中Ps，tPA，PAI1水平。结果 ①DPD 组术后6 h Ps含量降低（P<0.05）与对照组比较在术后6 h有显著性差异（P<0.05）；术后即刻至术后6 h血浆tPA活性降低（P<0.05）与PAI1含量升高（P<0.05），与对照组比较无统计学差异。②两组住院期间心血管病事件发生率无明显统计学差异。结论 Percusurge 远端保护装置能有效保护远端血管，减轻PTCA术后血小板的激活，减少再灌流后无复流的发生。
Abstract:
AIM To investigate influences of Percusurge distal protection device(DPD) on the level of Pselection,tissuetype plasminogen activator and plasminogen activator inhibitor1 during coronary intervention with acute myocardial infarction. METHODS 72 acute STelevation myocardial infarctiion patients received primary coronary intervention were included into this study. Patients were divided into two groups,test group:percusurge DPD were attempted during emergency PCI(n=39);control group:percusurge DPD were not attempted(n=33).Placing a right coronary artery catheter into the coronary sinus,blood samples were drawed to measure plasma Pselection(Ps)，tissue type plasminogen activator(tPA)，plasminogen activator inhibitor1(PAI1). RESULTS ①The test group Ps level after 6 hours PCI was significantly lower than that of control group (P<0.05). The tPA level decreased and PAI1 level increased significantly during the frist 6 hours after the PCI,but both of them were not significant different with control group (P<0.05)； ②The incidence rate of major adverse cardiac events（MACE） was no significant difference between two groups during hospitalization. CONCLUSION DPD can protect the distal vessels, reduce the activity of the platelet,and the noflow phenomenon in the thrombus laden arteries reperfusion in acute myocardial infarction.

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备注/Memo

备注/Memo:
收稿日期：2005-09-26.基金项目：西京医院科技创新基金项目资助（No.XJCX03M019） 通讯作者：李成祥，副主任医师，主要从事冠心病 PCI方面的研究 Tel：(029）84775183 Email:Li_chengxiang@yahoo.com 作者简介：郭瑄，副主任医师，硕士 Tel：（029）87630827
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