IABP在急性心肌梗死并心源性休克的临床观察

Clinical observation of IABP in acute myocardial infarction combined with cardiac shock

目的观察主动脉球囊反搏(IABP)在急性心肌梗死合并心源性休克患者救治中的疗效。方法选择急性心肌梗死合并心源性休克患者57例,其中29例应用IABP设为IABP组,28例未应用IABP组设为对照组,比较置入IABP前后IABP组患者血压、心率变化及两组血流动力学指标、30 d死亡率。结果 IABP组患者置入IABP后,患者收缩压、舒张压、心率明显改善(t分别=-7.03、-2.93、3.59,P均<0.05)。IABP组与对照组比较,第1天CI明显升高(t=2.37,P<0.05),第2天、第3天BNP明显下降(t分别=-2.22、-2.75,P均<0.05)。第1天、第2天、第3天和第4天,两组CO、CVP、PCWP比较,差异均无统计学意义(t分别=0.22、0.34、0.46、0.99;-0.39、-0.55、-0.34、1.57;0.79、0.73、0.70、1.00,P均>0.05)。IABP组30 d死亡率较对照组明显降低(χ2=4.14,P<0.05)。结论 IABP可以短时间内稳定急性心肌梗死合并心源性休克患者的血流动力学,并且降低患者的30 d死亡率。

Objective To observe the efficacy of IABP in patients with acute myocardial infarction combined with car-diac shock. Methods A total of 57 patients with AMI combined with CS were selected and divided into two groups ac-cording to whether applying IABP or not. The changes of blood pressure and heart rate in IABP group before and after ap-plying IABP were compared as well as hemodynamic indexes, 30-day mortality between two groups. Results After the application of IABP in IABP group,the systolic pressure, diastolic blood pressure and heart rate were significantly improved （t=-7.03,-2.93,3.59,P〈0.05）. Compared with the control group, the CI at first day in IABP group was significantly in-creased（t=2.37, P〈0.05）,the BNP at second and third days in IABP group were significantly decreased（t=-2.22, -2.75, P〈0.05）. The CO, CVP, PCWP from first day to forth day between two groups were not statistical different（t=0.22, 0.34, 0.46, 0.99; -0.39, -0.55, -0.34, 1.57; 0.79, 0.73, 0.70, 1.00, P〉0.05）. The 30-day mortality in IABP group was significantly lower than control group （χ2=4.14,P〈0.05）. Conclusion IABP can stabilize hemodynamic status in a short period of time and reduce the 30-day mortality.