主动脉球囊反搏联合急诊PCI治疗ST段抬高型心肌梗死合并心源性休克的效果

Effect of Aortic Balloon Counterpulsation Combined with Emergency PCI in the Treatment of ST Segment Elevation Myocardial Infarction Complicated with Cardiogenic Shock

目的探讨主动脉球囊反搏联合急诊经皮冠状动脉介入术(PCI)治疗ST段抬高型心肌梗死(STEMI)合并心源性休克的效果。方法回顾性分析2020年3月至2021年3月南阳南石医院收治的102例STEMI合并心源性休克患者的一般资料,根据治疗方式分为常规组(51例)和研究组(51例)。常规组接受急诊PCI治疗,研究组接受主动脉球囊反搏联合急诊PCI治疗,两组均持续治疗1个月后观察效果。对比两组患者临床疗效及TIMI分级、降钙素原(PCT)水平以及两组治疗期间不良反应发生情况。结果研究组总有效率高于常规组(P<0.05)。两组患者TIMI分级为Ⅰ、Ⅱ、Ⅳ级对比,差异无统计学意义(P>0.05),两组TIMI分级为Ⅲ级对比,差异有统计学意义(P<0.05),且研究组Ⅲ级占比高于常规组(P<0.05)。治疗前,两组PCT水平对比差异无统计学意义(P>0.05);治疗1个月后,两组PCT水平较治疗前降低(P<0.05),且研究组低于常规组(P<0.05)。两组治疗期间总不良反应发生率对比差异无统计学意义(P>0.05)。结论主动脉球囊反搏联合急诊PCI治疗STEMI合并心源性休克患者的效果显著,TIMI分级以Ⅲ级为主,可减轻炎症反应。

Objective To investigate the effect of aortic balloon counterpulsation combined with emergency percutaneous coronary intervention(PCI)in the treatment of ST segment elevation myocardial infarction(STEMI)complicated with cardiogenic shock.Methods The general data of 102 patients with STEMI complicated with cardiogenic shock treated in Nanyang Nanshi Hospital from March 2020 to March 2021 were analyzed retrospectively.They were divided into routine group(51 cases)and study group(51 cases)according to treatment methods.The routine group received emergency PCI,and the study group received aortic balloon counterpulsation combined with emergency PCI.The effects of the two groups were observed after continuous treatment for 1 month.The clinical efficacy,TIMI grade,procalcitonin(PCT)level and adverse reactions were compared between the two groups.Results The total effective rate of the study group was higher than that of the routine group(P<0.05).There was no difference in TIMI gradeⅠ,ⅡandⅣbetween the two groups(P>0.05).There was significant difference in TIMI gradeⅢbetween two groups(P<0.05),and the percentage of gradeⅢin the study group was higher than that in the routine group(P<0.05).Before treatment,there was no significant difference in PCT level between the two groups(P>0.05).After one month of treatment,the levels of PCT in the two groups were lower than that before treatment(P<0.05),and the level of PCT in the study group was lower than that in the routine group(P<0.05).There was no significant difference in the incidence of total adverse reactions between the two groups during treatment(P>0.05).Conclusion Aortic balloon counterpulsation combined with emergency PCI is effective in the treatment of STEMI patients with cardiogenic shock,and TIMI grade is mainly gradeⅢ,which could reduce inflammation.