经皮机械循环支持设备治疗急性心肌梗死并发心源性休克研究进展

Research progress of percutaneous mechanical circulation support device in treatment of acute myocardial infarction complicated with cardiac shock

当前急诊经皮冠脉介入治疗技术日趋成熟规范,新型抗血小板药物广泛应用,主动脉球囊反搏泵(IABP)逐渐普及,但急性心肌梗死并发心源性休克患者死亡率仍居高不下。对此,包括Impella、TendemHeart和ECMO在内的经皮机械循环支持设备可通过提供较之IABP更强的血流动力学支持而有望改善心源性休克患者预后。尽管现有临床证据较少,仍不足以充分证明应用经皮机械循环支持设备救治的临床获益,同时应用后血管和全身并发症不容忽视,但随着技术的进步和临床应用经验的日益增加,经皮机械循环支持设备有望成为心梗并发心源性休克患者成功救治的关键所在。

Currently, emergency percutaneous coronary intervention is becoming more and more accepted and standardized, new antiplatelet drugs are widely used, aortic balloon pump (IABP) is becoming more and more popular;however, the mortality of patients with acute myocardial infarction with cardiogenic shock is still high. Percutaneous mechanical circulatory support devices, including Impella, TendemHeart and ECMO, are expected to improve the prognosis of patients with cardiogenic shock by providing stronger hemodynamic support than IABP. Although the little clinical evidence available cannot fully demonstrate the clinical benefits of using percutaneous mechanical circulation support devices and the vascular and systemic complications cannot be ignored, percutaneous mechanical circulation support equipment is expected to be the key to successful treatment of myocardial infarction patients with cardiogenic shock with the technology development and increasing clinical experience.