重症急性心肌梗死患者主动脉球囊反搏辅助下PCI治疗的疗效

Effect of PCI with Aid of Intra-aortic Balloon Pumping Counterpulsation on Severe Acute Myocardial Infarction

目的观察重症急性心肌梗死(AMI)患者在主动脉球囊反搏(intra-aortic balloon pumping,IABP)辅助下行经皮冠状动脉治疗(PCI)的效果。方法对11例重症AMI并发心源性休克及低心排血量综合征患者(观察组)应用IABP治疗,与同期15例重症AMI并发心源性休克及低心排血量综合征但采取单纯药物保守和择期PCI治疗的患者(对照组)进行比较,对比治疗后1年时的随访结果。结果 11例患者均顺利脱机,1周内抢救成功率为11/11;治疗1年后随访,再梗死率为1/11,存活率达到了10/11。两组患者的1年存活率比较,差异有统计学意义(P=0.038);而两组患者的1周内再梗死率、1周内存活率比较,差异无统计学意义(P值分别为0.492和1.000)。结论 IABP是抢救重症AMI患者的一种有效的辅助治疗措施,同时应该尽早使用,但使用时需注意其对肾功能以及血小板的影响。

Objective To evaluate the effect of percutaneous coronary intervention（PCI） with the aid of intra-aortic balloon pumping（IABP） on severe acute myocardial infarction.Methods Eleven severe AMI patients complicated by cardiogenic shock and low cardiac output syndrome（study group） receiving IABP therapy were compared with 15 receiving conservative treatment of drugs and elective PCI.And the follow-up lasted 1 year.Results All 11 patients had a successful off-line with an achievement ratio of 100%.The re-infarction rate was 1/11 1 year after treatment,with a survival rate of 10/11.There was significant difference in 1-year survival between 2 groups（P=0.038）,but not in 1-week re-infarction rate and 1-week survival（P= 0.492,1.000,respectively）.Conclusion IABP,an effective adjuvant treatment for severe AMI,should be used earlier,but its effects on renal function and platelets should be paid attention to.