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|本期目录/Table of Contents|

血栓抽吸导管在冠脉介入治疗中对血栓病变TIMI血流的影响

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2010年第6期
页码:
891-892,900
栏目:
临床研究
出版日期:
2010-08-23

文章信息/Info

Title:
Effect of thrombus aspiration catheter on TIMI flow during percutaneous coronary intervention for patients with thrombotic burden lesion
作者:
王智; 唐强; 陈学智; 史振涛
北京大学首钢医院心内科，北京 100144
Author(s):
WANG Zhi;  TANG Qiang;  CHEN Xue-zhi;  SHI Zhen-tao
Department of Cardiology, Shougang Hospital, Peking University, Beijing 100041, China
关键词:
急性冠脉综合征; 血栓病变; 抽吸导管; 心肌梗死溶栓试验血流
Keywords:
acute coronary syndrome;  thrombotic burden lesion;  thrombus aspiration catheter;  thrombolysis;  myocardial infarction flow
分类号:
R543.3
DOI:
-
文献标识码:
A
摘要:
目的: 探讨血栓抽吸导管在经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)中对于血栓病变TIMI血流的影响。方法： 对我院1年来急性冠脉综合征(ACS）冠状动脉造影（CAG）显示靶病变相关血管(target- related artery,TRA) 血栓负荷的患者48（男35，女13)例，年龄（58±8）岁，随机分成试验组（血栓抽吸＋PCI，n=25）与对照组（直接PCI，n=23）。收集所有病例的临床和CAG资料，对比两组患者PCI术中相关血管心肌梗死溶栓试验(thrombolysis in myocardial infarction，TIMI)血流情况。结果： 试验组患者PCI术中无复流及慢血流发生率明显低于对照组（0% vs. 17%，P<0.05），两组患者PCI术后TIMI Ⅲ级血流无显著差异。结论： 对于冠脉有血栓负荷病变进行血栓抽吸可以明显改善ACS患者IRA远端的前向血流，降低无复流现象的发生。
Abstract:
AIM：To study the effect of thrombus aspiration catheter on TIMI flow during percutaneous coronary intervention (PCI) for patients with thrombotic burden lesion. METHODS: Forty-eight patients (35 men and 13 women, mean age 58±8 years) with acute coronary syndrome (ACS) were divided into two groups: intracoronary thrombus aspiration+PCI group (n=25) and primary PCI group (n=23). Effects of thrombus aspiration catheter on TIMI flow during procedure were observed. RESULTS: The rates of slow-flow and no-reflow in intracoronary thrombus aspiration+PCI group was lower than that in primary PCI group (0% vs. 17%, P<0.05) and no significant difference was observed in TIMI III flow grade between the two groups after procedure. CONCLUSION: Intracoronary thrombus aspiration+PCI is a more effective reperfusion method before PCI for ACS patients with lower rates of no-reflow.

参考文献/References

［1］The Thrombolysis in Myocardial Infarction (TIMI) trial. Phase I findings. TIMI Study Group［J］. N Engl J Med, 1985, 312(14):932-936.

［2］Morishima I, Sone T, Okumura K, et al. Angiographic no-reflow phenomenon as a predictor of adverse long-term outcome in patients treated with percutaneous transluminal coronary angioplasty for first acute myocardial infarction［J］. J Am Coll Cardiol, 2000, 36（4）：1202-1209.

［3］Waksman R, Douglas JS Jr, Scott NA, et al. Distal embolization is common after directional atherectomy in coronary arteries and saphenous vein grafts［J］. Am Heart J, 1995, 129（3）:430-435.

［4］Rezkalla SH, Kloner RA. No-reflow phenomenon［J］. Circulation, 2002, 105(5):656-662.

［5］Limbruno U, Micheli A, De Carlo M, et al. Mechanical prevention of distal embolization during primary angioplasty: safety, feasibility, and impact on myocardial reperfusion［J］. Circulation, 2003, 108（2）:171-176.

［6］ Lepper W, Sieswerda GT, Vanoverschelde JL, et al. Predictive value of markers of myocardial reperfusion in acute myocardial infarction for follow-up left ventricular function［J］. Am J Cardiol, 2001, 88(12):1358-1363.

［7]Silva-Orrego P, Colombo P, Bigi R, et al. Thrombus aspiration before standard primary angioplasty improves myocardial reperfusion in acute myocardial infarction:the DEAR-MI (Dethrombosis to Enhance Acute Reperfusion in Myocardial Infarction) Study［J］. J Am Coll Cardiol, 2006, 48(8):1552-1559.

备注/Memo

备注/Memo:
收稿日期：2009-11-23.作者简介：王智，硕士生Email: docwz6328@sina.com
更新日期/Last Update: 2010-08-22