主动脉内球囊反搏对行冠状动脉旁路移植术患者临床指标的影响

Effect of Intra-Aortic Balloon Pump on Clinical Indicators of Patients Undergoing Coronary Artery Bypass Grafting

目的探讨术前主动置入和术中/术后被动置入主动脉内球囊反搏(Intra-Aortic Ballon Pump,IABP)对行冠状动脉旁路移植术(Coronary Artery Bypass Grafting,CABG)的重症冠心病患者临床指标的影响。方法回顾性分析2013年3月至2020年12月我院应用IABP的53例重症冠心病患者的临床资料,所有患者均接受CABG治疗,分析并比较IABP干预前后患者血流动力学、超声心动图、心肌纤维化标志物指标的水平。结果接受IABP治疗后,患者MAP、CI、尿量等血流动力学指标水平均高于治疗前;左室舒张末期内径、左室射血分数、每搏输出量等超声心动图指标水平均高于治疗前,左室舒张末期容积指标水平低于治疗前;IMP-1、MMP-2、Ⅲ型前胶原氨基端肽、Ⅰ型胶原氨基端延长肽等心肌纤维化标志物指标水平均低于治疗前,差异均有统计学意义(P<0.001)。结论术前合理使用IABP可有效改善行CABG治疗的重症冠心病患者的血流动力学、超声心动图等临床指标水平,利于患者预后,值得临床推广。

Objective To explore the effect of active preoperative implantation and intraoperative/postoperative passive intra-aortic balloon pump(IABP)on the clinical indicators of severe coronary heart disease patients undergoing coronary artery bypass grafting(CABG).Methods The clinical data of 53 patients with severe coronary heart disease who used IABP in our hospital from March 2013 to December 2020 were retrospectively analyzed.All patients received CABG treatment.The levels of hemodynamics,echocardiography,and myocardial fibrosis markers before and after IABP intervention were analyzed and compared.Results After treatment with IABP,the patient’s hemodynamic indicators such as MAP,CI,and urine output were higher than before treatment.Echocardiographic indicators such as LVEDD,LVEF,SV were higher than before treatment,and LVESV indicator levels were lower than before treatment.The levels of myocardial fibrosis markers such as IMP-1,MMP-2,PⅢNP,PⅠNP were lower than before treatment,and the differences were statistically significant(P<0.001).Conclusion Preoperative rational use of IABP can effectively improve the level of hemodynamics,echocardiography and other clinical indicators of patients with severe coronary heart disease treated with CABG,which is beneficial to the prognosis of patients and is worthy of clinical promotion.