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目的:探讨急性ST段抬高型心肌梗死急诊经皮冠状动脉介入治疗(PCI)中应用GOODMAN血栓抽吸装置联合术前阿托伐他汀强化治疗对心肌组织灌注及临床预后的影响。方法:选择梗死相关血管心肌梗死溶栓试验血流0级的急性ST段抬高型心肌梗死患者80例,随机分为血栓抽吸联PCI术前阿托伐他汀强化治疗组(试验组)40例和标准PCI治疗组(对照组)40例。比较两组患者术后心肌梗死溶栓试验(TIMI)血流分级、TIMI心肌灌注分级(TMPG)、心电图ST段回落百分比、左心室射血分数(LVEF)及住院期间主要心血管不良事件(MACE)。结果:试验组TIMI血流分级、TMPG、ST段回落百分比、LVEF均明显优于对照组(P<0.05)。两组患者住院期间MACE发生率比较,差异无统计学意义(P>0.05)。结论:在急性ST段抬高型心肌梗死急诊经皮冠状动脉介入治疗(PCI)中应用血栓抽吸联合术前阿托伐他汀强化治疗安全可行,可有效清除冠状动脉内血栓,改善心肌组织灌注及术后心脏功能,并且不增加主要心血管事件的发生率。
Objective: To investigate the effect of using GOODMAN thrombus aspiration device combined with preoperative atorvastatin on myocardial perfusion and clinical prognosis in patients with acute ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention (PCI). Methods: Eighty patients with acute ST-segment elevation myocardial infarction with grade 0 blood flow were selected and randomly divided into thrombectomy combined with atorvastatin treatment group Cases and standard PCI treatment group (control group) 40 cases. TIMI flow classification, TIMI myocardial perfusion grading (TMPG), ST-segment fall percentage, left ventricular ejection fraction (LVEF), and major cardiovascular adverse events during hospitalization (MACE) were compared between the two groups ). Results: TIMI flow classification, percentage of TMPG, ST-segment fall, LVEF in the experimental group were significantly better than those in the control group (P <0.05). There was no significant difference in MACE incidence between the two groups during hospitalization (P> 0.05). Conclusion: It is safe and feasible to use thrombus aspiration combined with preoperative atorvastatin to treat acute ST-segment elevation myocardial infarction in percutaneous coronary intervention (PCI), which can effectively remove thrombus in coronary artery and improve myocardial perfusion And postoperative cardiac function, without increasing the incidence of major cardiovascular events.