| Objective:With the rapid development of economic and social pressures increasing in recent years,smoking,obesity and physical activity decreased,crowd of hypertension,hyperlipaema and hyperglycema,high homocysteine,homocysteine and so on traditional coronary heart disease(CHD)risk factors are on the rise in our country,,and the increasingly younger,has become major diseases to human health.ST-segment elevation myocardial infarction(STEMI)is the most serious.This study analyses the clinical datas in patients with STEMI treated from March 2011 to March 2014 in CCU department of Jinghai hospital.To investigate the influence of thrombus aspiration on ventricular remodeling of heavy load evaluation of thrombus patients with ST-segment elevation myocardial infarction(STEMI)who underwent emergency percutaneous coronary intervention(PCI)and its predicative value for patients' prognosis.Methods:Diagnosed with STEMI line emergency PCI of 308 cases who hospitalized in our department of cardiology from March 2011 to March 2014.152 patients for heavy load evaluation of thrombus received thrombus aspiration during primary PCI as thrombus aspiration group,and the remaining 156 patients for light load evaluation of thrombus without thrombus aspiration were set as control group.Indexes of myocardial perfusion levels such as ST-segment resolution 2 hours after PCI and TIMI myocardial perfusion grade were measured in all patients.All patients accepted echocardiography examinations at the tenth day after PCI.To compare the differences of left ventricular end-diastolic diamete(LVED)and left ventricular ejection fraction(LVEF)of the two groups,secondary end points major cardiac adverse events(MACE)at 6 months.Results:Thrombus aspiration can effectively aspirate thrombus,thereby improving myocardial reperfusion.There was no statistical difference between the ratio in two groups of ST-segment fell more than 50%[78.9%(120/152)vs 71.2%(111/156),?2=0.428,p=0.669],.But for ST-segment fell more than 70%,the ratio of the thrombus aspiration group was significantly higher than that in the control group[73.7%(112/152)vs 47.4%(74/156),?2=4.701,p=0.001].Two groups of patients were treated by echocardiography tenth days after PCI,showed the LVED in the thrombus aspiration group was lower than that in the control group [(50.2±4.7)mm vs(51.6±4.6)mm,t=2.642,p=0.008],while the LVEF value was higher than that in the control group[(56.9±4.9)% vs(49.4±4.2)%,t=14.434,p=0.001].Recurrent angina pectoris decreased signnfcantly in the thrombus aspiration group at 6 months[4.61%(7/152)vs 10.90%(17/156),?2=2.056,p=0.040],There was no significant difference in the event of cardiovascular desth,recurrent MI heart failure [2(1.31%)vs 2(1.28%),p=0.979;5(3.29%)vs 8(5.13%),p=0.423;1(0.65%)vs 2(1.28%),p=0.578].Conclusion:Patients with STEMI for heavy load evaluation of thrombosis disease adopt thrombus aspiration that undergoing emergency PCI,not only can prevent the distal blood vessel embolism,improve myocardial reperfusion,especially microcirculation reperfusion,but also can improve the left ventricular systolic function and the prognosis of patients. |
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