IABP运行时间对ACS病人院内结局的影响

EFFECT OF INTRA-AORTIC BALLOON PUMP DURATION ON IN-HOSPITAL OUTCOMES OF PATIENTS WITH ACUTE CORONARY SYNDROME

目的探讨主动脉内球囊反搏术(IABP)持续运行时间对急性冠状动脉综合征(ACS)病人行经皮冠状动脉介入术(PCI)后院内结局的影响,并分析病人院内死亡独立危险因素。方法收集行PCI辅以IABP治疗的ACS病人82例,根据IABP运行时间分为A组23例(≤24h)和B组59例(>24h),比较两组的院内死亡率及其他不良事件发生率;采用多变量Logistic回归分析病人院内死亡的独立危险因素。结果 A组和B组病人血红蛋白丢失量分别为(5.83±5.32)、(12.93±15.08)g/L,差异有显著性(t=3.151,P<0.05),两组院内死亡率、肢体缺血事件发生率、术后支架内血栓发生率及术后感染率差异均无统计学意义(P<0.05)。高龄、女性、吸烟、合并心源性休克、肌酐水平升高和左心室射血分数(LVEF)下降为行PCI的ACS病人院内死亡的独立危险因素。结论IABP运行时间延长可能会增加术后出血风险,但不增加院内死亡率及术后肢体缺血、术后支架内血栓及术后感染发生率。年龄、性别、吸烟、心源性休克、肌酐水平和LVEF可以预测此类病人的短期预后。

Objective To investigate the effect of intra-aortic balloon pump（IABP）duration on the in-hospital outcomes of patients with acute coronary syndrome（ACS）after percutaneous coronary intervention（PCI）,as well as independent risk factors for hospital death. Methods A retrospective analysis was performed for the clinical data of 82 ACS patients who underwent PCI and IABP,and according to the IABP duration,these patients were divided into group A with 23 patients（≤24 h）and group B with 59 patients（24 h）.The two groups were compared in terms of hospital death rate and the incidence rate of adverse events.A multivariate logistic regression analysis was performed to identify the independent risk factors for hospital death.Results There was a significant difference in hemoglobin loss between groups A and B（（5.83±5.32）g/L vs（12.93±15.08）g/L,t=3.151,P〈0.05）.There were no significant differences between the two groups in hospital death rate,incidence rates of limb ischemia and stent thrombosis after surgery,and postoperative infection rate（P〈0.05）.Old age,female sex,smoking,presence of cardiogenic shock,an elevated creatinine level,and a reduction in left ventricular ejection fraction（LVEF）were independent risk factors for hospital death in ACS patients after PCI. Conclusion Prolonged IABP duration may increase the risk of postoperative bleeding,but it does not increase hospital death rate and the incidence rates of postoperative limb ischemia,stent thrombosis,and infection.Age,sex,smoking,cardiogenic shock,creatinine level,and LVEF can be used to predict the short-term prognosis of ACS patients.