摘要
目的 评价STEMI急诊PCI中应用AngioguardTMDPD的疗效和安全性。方法 自 2 0 0 2年 7月至 12月 ,共 4 0例接受急诊PCI治疗的STEMI患者纳入研究 ,其中AngioguardTMDPD组 2 1例 ,对照组 19例。比较两组间的基础临床状况、造影情况、介入治疗结果以及住院期间随访情况 ,病变血管术后均行TIMI分级、TIMI计帧和心肌Blush分级。结果 AngioguardTM DPD组中 ,19例获得成功(90 4 % ) ,网篮内均有多少不等的血栓样物质。两组间的基础临床状况、术前造影情况和术后TIMI3级 (10 0 %和 84 % ,P =0 2 3)差异均无显著性。但DPD组与对照组间发生远端小血管栓塞为 (5 2 %和36 8% ,P =0 0 4 2 ) ;两组的TIMI帧数为 (19 9± 5 7和 30 3± 9 6 ,P <0 0 0 1) ;Blush 3级获得率为(73 7%和 31 6 % ,P =0 0 2 2 )。DPD组术后CK峰值浓度较低 ,ST段回落幅度大 ,近期左室射血分数高 ,均优于对照组 (P <0 0 5 )。两组住院期间均无主要心血管事件发生。结论 在某些STEMI病人中 ,急诊PCI时应用AngioguardTM DPD安全可行 ,可改善患者术后的远端心肌血流灌注 ,提高患者的心功能。应用TIMI计帧法和Blush分级法优于应用TIMI分级法。
Objective To evaluate the feasibility of Angioguard TM DPD during emergency PCI in the patients with acute STEMI. Methods From July 2002 to Dec. 2002, 40 acute STEMI patients who received primary coronary intervention were included into this study. Patients were divided into two groups according to whether Angioguard TM DPD was attempted during emergency PCI. The basic clinical characteristics, angiographic results, and follow-up data before discharge were compared. TIMI grade, TIMI Frame Count and myocardial blush grade were performed in all cases after emergency PCI. Results Success was achieved in 19 patients (19/21, 90.4%) by Angioguard TM DPD with varies extent of material from the basket. There was no significant difference between the two groups in basic clinical characteristics, angiogram before PCI (P>0.05) and TIMI 3 flows achieved in IRAs after PCI (100% vs 84%, P=0.23). Less distal embolizations (5.2% vs 36.8%, P=0.042), Better TIMI frame count (19.9±5.7 vs 30.3±9.6, P<0.001) and better percentage of blush grade 3 of IRAs (73.7% vs 31.6%, P=0.022) were achieved in DPD group. Follow-up date before discharge showed there were lower peak serum CK levels, higher LVEF and faster ST segment resolution in the Angioguard TM group after PCI (P<0.05). There was no MACE in both groups. Conclusion Application of Angioguard TM DPD during emergency PCI in some patients with acute STEMI was safe and effective which could improve distal coronary perfusion and left ventricular function. TIMI Frame Count and myocardial Blush grade in evaluation of distal myocardial blood perfusion during emergency PCI was superior to that of TIMI grade in this study.
出处
《中国介入心脏病学杂志》
2003年第3期120-122,共3页
Chinese Journal of Interventional Cardiology
