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Objective: To investigate the application thrombus aspiration device GuardWire PlusTM line of thrombus aspiration for acute ST elevation myocardial infarction (STEMI) neuroendocrine, cardiac enzymes, TIMI blood flow and corrected TIMI flow frames count change and its clinical value. METHODS: September 2004 to January 2007 in our hospital emergency PCI of 72 patients with acute ST elevation myocardial infarction patients were divided into two groups, suction group (TA): stenting after thrombus aspiration group ; non-suction group (NTA group): PCI group. TA group of 38 cases, NTA group of 34 patients on the day of surgery, after one day, two days, three days, five days were measured in peripheral blood endothelial prime (ET), plasma renin activity (PRA), aldosterone ( ALD), angiotensin II (by Ang Ⅱ), norepinephrine (NE), epinephrine (E) concentration level. Preoperative and postoperative 4h, 8h, 12h, 16h, 24h, 2 days, 3 days, 5 days were measured in peripheral blood myoglobin (MYO), creatine kinase isoenzyme (CK-MB), troponin Ⅰ (CTNI) concentration level. And were traced the neuroendocrine concentration time curve. Conventional coronary angiography after stent implantation, myocardial perfusion measured patients after stent implantation TIMI flow and corrected TIMI flow the frames count (CTFC). ST segment, a week after surgery and three months of application of echocardiography determination of left ventricular ejection fraction (LVEF), the evaluation of cardiac function after 2 hours. Results: Two groups of patients were successfully implanted stents, preoperative patients neuroendocrine factors were significantly increased between the two groups there is no difference (P gt; 0.05). Concentration-time curve display postoperative neuroendocrine factors decreased rapidly, postoperative ET, PRA, Ang II, ALD, NE, E, neuroendocrine factors on postoperative day 1 or 2 days down suction group than in the non-suction group was significantly (P lt; 0.05), after three days and five days between the two groups decreased concentration levels did not differ (P gt; 0.05). Preoperative two groups MYO, CK-MB, CTNI levels there is no difference (P gt; 0.05), the two groups of patients after MYO, CK-MB level no difference in postoperative TA group CTNI decrease NTA group fast, enzymes peak TA group compared with NTA group in advance, but no significant difference (P gt; 0.05). And neuroendocrine and CTNI change was a positive correlation (P lt; 0.01). Conventional coronary angiography after stent implantation, myocardial perfusion in patients the TIMI flow reached two or three, but the differences between the two groups was not obvious (P gt; 0.05). TIMI flow, the number of frames between the two groups after correction count was significantly different (P lt; 0.05). 2 hours after ST segment amplitude is greater than or equal to 50% as a standard, between the two groups there is no difference (P GT; 0.05). A week after two groups of left ventricular function is no difference (P gt; 0.05), left ventricular function is significantly different in the two groups of three months, the TA group LVEF was significantly higher than the NTA group (P lt; 0.05). Conclusion: The more direct thrombus aspiration treatment of acute STEMI PCI can significantly improve the deterioration of the neuroendocrine changes, the CTNI enzyme peak advance to mitigate damage to the myocardium, myocardial perfusion improved, there may be a potential protective effect on cardiac function.
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