老年人急性心肌梗死PCI术后IABP支持治疗

Intra-aortic balloon pump supporting therapy after PCI to aged in-patients who were diagnosised acute myocardial infarction(AMI) complicated with myocardial dysfunction and/or cardiogenic shock

目的探讨主动脉球囊反搏(Intra-aorticballoonpump,IABP)在老年急性心肌梗死合并心功能不全的病人经皮冠状动脉介入术(percutaneouscoronaryintervention,PCI)后的应用价值。方法2004年5月～2005年6月因急性心肌梗死入院的老年人合并心功能不全52例,年龄(67.28±5.57)岁,20例PCI术后行IABP治疗,32例未行IABP治疗为对照组,在其他治疗均相似的情况下,观察两组病人术前、术后1周心脏左室射血分数(EjectivefractionEF)值及心功能不全的临床表现。结果两组病人心功能较PCI术前均有明显恢复(P<0.01),行IABP支持治疗老年急性心肌梗死组病人的心功能较非IABP组恢复差异有显著性(P<0.01)。结论老年人急性心肌梗死PCI术后,IABP支持治疗可以通过减低左心室压力而减少心肌氧耗,增加缺血心肌的氧供给,同时提高冠脉血流灌注改善心功能,故老年性AMI合并心功能不全,PCI术后及早应用I-ABP对短期心功能恢复是有效的。

[Objective] To discuss the application value of intra-aortic balloon pump（IABP） in the aged in-patients who were undergone pereutaneous coronary intervention（PCI） after acute myocardial infarction（AMI） complicated with myocardial dysfunction and/or cardiogenic shock. [Methods] Choosed 44 cases who were diagnostic AMI and companied by heart dysfunction and/or cardiogenic shock, 20 cases were performed IABP after PCI and 32 cases were control group. Under the similar therapy, observed the left ventricular ejective fraction before and after 1 week of PCI in two groups, as well as clinical features. [Results] After PCI, two group in-patients＇ heart function had significantly recovered than that of before PCI, and in IABP group, 20 cases＇ heart function could be improved effectively by using IABP than control group and clinical features became better. [Conclusion] IABP supporting therapy can improve left ventricular function through increase myocardial oxygen and decrease left ventricular pressure so that decrease myocardial oxygen demand, at the same time, IABP can increase coronary artery peffusion as well as increase myocardial ejective fraction. Early supporting therapy of IABP after PCI for elderly AMI is necessary and effective.