IABP支持对AMI并发心源性休克患者急症PCI术后的影响

Influence of IABP on Patients with AMI Complicated with CS After PCI Operation

目的探讨主动脉内球囊反搏（IABP）支持对急性心肌梗塞（AMI）并发心源性休克（CS）患者经皮冠状动脉介入（PCI）术后的影响。方法选取82例急性心肌梗死并心源性休克患者为研究对象,均在IABP支持下行PCI手术。比对治疗前后心脏超声指标、心肌酶（CK-MB）水平变化及Killip分级改善差异,记录术后相关并发症发生率及死亡率。结果所有受试者均成功置入IABP且完成PCI手术,IABP平均反搏时间为（74.7±22.9）h;即刻病情改善50例（61.0%）;治疗后,LVEF水平均较治疗前明显提高,且LVEDd、LVEsd等心脏超声指标及CK-MB水平则较治疗前显著降低（P〈0.05）;Killip分级达到Ⅰ~Ⅱ级者共73例,无Ⅳ级报告,同治疗前对比差异有统计学意义（P〈0.05）;术后1个月内死亡33例（40.2%）,3个月内死亡45例（54.9%）;并发症发生率为12.2%。结论对AMI并CS患者采用IABP支持下PCI手术方案,疗效确切,值得临床推广。

Objective To explore the influence of intra aortic balloon counterpulsation （IABP） on patients with acute myocardial in-farction （AMI） complicated with cardiac shock （CS） after percutaneous coronary intervention （PCI） operation. Methods 82 patients with AMI and CS were selected as the research object, and all of them received the PCI operation with the support of IABP. The changes of myocardial enzymes, cardiac ultrasound index （CK-MB） and differences in Killip grading improvement after treatment were compared with those before treatment. The rate of related incidence of complications and mortality were recorded. Results All of the objects were successfully implanted with IABP and finished the PCI operation. The average time of IABP counterpulsation was （74.7±22.9） h. There were 50 cases （61%） in which condition had been immediate improved. After the treatment, the level of LVEF were obviously improved, and the echocardiographic parameters of LVEDd, LVEsd, as well as CK-MB levels were signifi-cantly lower than before （P〈0.05）. There were 73 cases in total reaching the Killip grade from grade I to II without report of gradeⅣ ,and the differences were statistically significant, compared with those before the treatment （P〈0.05）. 33 patients died （40.2%） in 1 months after operation, and 45 patients died （54.9%） in 3 months. The incidence rate of complication was 12.2%. Conclusion The effect of PCI operation with the support of IABP for patients with AMI complicated with CS is obvious, therefore it is worth the clinical promotion.