主动脉内球囊反搏术在急性心肌梗死合并心源性休克行冠状动脉支架置入术中的临床评价

Clinical evaluation of intra aortic balloon couterpulsation in percutaneous coronary interention for patients with acute myocardial infarction combined with cardiogenic shock

目的评价主动脉内球囊反搏术(IABP)在急性心肌梗死(AMI)合并心源性休克(CS)行经皮冠状动脉介入治疗(PCI)中的疗效。方法AMI合并CS的52例患者一经确诊即予急诊IABP循环支持治疗,与未经IABP治疗的48例患者(对照组)进行比较,两组均在常规用药基础上行PCI治疗。观察两组患者IABP前后的心功能指标、PCI术后1周内病死率及血管再闭塞事件发生率。结果治疗组进行IABP后桡动脉内测舒张压、平均动脉压(MAP)、心脏指数(CI)、心输出量(CO)、每搏输出量(SV)、射血分数(EF)较术前明显升高(P<0.05或P<0.01),而肺毛细血管楔压(PCWP)较术前明显降低(P<0.05),治疗组病死率显著低于对照组(P<0.05),治疗组血管再闭塞事件发生率显著低于对照组(P<0.05)。结论IABP可显著改善心功能,降低AMI合并CS患者的死亡率及血管再闭塞发生率。

Objective To evaluate the therapeutic effect of intra - aortic balloon couterpulsation in percutaneous coronary intervention for patients with acute myocardial infarction combined with cardiogenic shock. Methods Fifty - two AMI patients combined with CS diagnosed were treated with a verdict by the IABP circulatory support emergency treatment,with the same period, 48 patients of the same disease without IABP treatment as a control group to compare. Application of PCI treatment in both groups on the basis of conventional medication. Before and after IABP that were observed in patients with cardiac function, fatali- ty after one week of PC] and the incidence of vascular re - occlusion. Results Neice radial artery diastolic pressure, MAP, CI, CO, SV and EF in the treatment group were significantly higher than that before operation （ P 〈 0.05 or P 〈 0. 05 ） , while PC- WP was significantly lower than that before operation （ P 〈 0.05 ）, the mortality of treatment group was significantly lower than that in the control group （ P 〈 0.05 ）, the incidence rate of vessel re - occlusion in treatment group was significantly lower than tha, in the control group （ P 〈 0.05 ）. Conclusion IABP can significantly improve cardiac function and reduce mortality in patients with AMI complicated with CS and reduce the rate of vessel re - occlusion.