基于美国心血管造影和介入学会心源性休克分类评估主动脉内球囊反搏与预后的关系  

The association of intra-aortic balloon pump with prognosis of cardiogenic shock based on Society for Cardiovascular Angiography and Interventions classification

作　　者：赵卓贤 梁海青[1] 王钊[1] 曹宁 郭牧[1] 宋昱[1] Zhao Zhuoxian;Liang Haiqing;Wang Zhao;Cao Ning;Guo Mu;Song Yu(Cardiac Care Unit(CCU),TEDA International Cardiovascular Hospital,Cardiovascular Clinical College of Tianjin Medical University,Tianjin 300457,China)

机构地区：[1]天津医科大学心血管临床学院泰达国际心血管病医院心脏重症监护室,天津300457

出　　处：《中华医学杂志》2023年第10期752-756,共5页National Medical Journal of China

基　　金：泰达国际心血管病医院院内基金(2022-TD-004);天津市医学重点学科(专科)建设项目(TJYXZDXK-020A)

摘　　要：评估主动脉内球囊反搏(IABP)是否能够改善基于美国心血管造影和介入学会(SCAI)分类的心源性休克C期(典型期)、D(恶化期)和E期(终末期)的患者预后。检索本院信息系统数据库,所纳入的满足心源性休克诊断标准的患者遵循相同的治疗原则。分类分析SCAI心源性休克C期、D/E期中应用IABP与患者1和6个月生存率之间是否相关。本研究共纳入心源性休克C期141例,心源性休克D/E期267例。心源性休克C期患者中,应用IABP是提高患者1个月生存率[ OR 值(95% CI )为0.372(0.171~0.809), P =0.013]和6个月生存率[ OR 值(95% CI )为0.401(0.190~0.850), P =0.017]的相关因素;校正经皮冠状动脉介入或冠状动脉旁路移植术(PCI/CABG)后,与提高1和6个月生存率相关的因素是PCI/CABG。心源性休克D/E期患者中,应用IABP是提高1个月生存率的相关因素[ OR 值(95% CI )为0.053(0.012~0.236), P =0.001]。因此,IABP可辅助心源性休克C期患者渡过PCI/CABG围手术期并提高生存率,IABP可能延长心源性休克D/E期患者的短期生存。The study aimed to evaluate whether an intra-aortic balloon pump(IABP)could improve the prognosis of patients with cardiogenic shock(CS)of Stage C(Classic),Stage D(Deteriorating),and Stage E(Extremis)based on Society for Cardiovascular Angiography and Interventions(SCAI)classification.The hospital information database was searched,and the patients who met the diagnostic criteria of CS were included and treated following the same protocol.The association between IABP and the survival of patients at 1 month and 6 months were analyzed separately in SCAI stage C of CS,and stages D and E of CS.The multiple logistic regression models were used to separately evaluate whether IABP was independently associated with increased survival in stage C of CS,and stages D and E of CS.A total of 141 patients with stage C of CS and 267 patients with stages D and E of CS were included.In stage C of CS,IABP was significantly associated with improved survival of patients at 1 month[adjusted OR(95%CI)=0.372(0.171-0.809),P=0.013]and survival at 6 months[adjusted OR(95%CI)=0.401(0.190-0.850),P=0.017].However,when percutaneous coronary intervention or coronary artery bypass grafting(PCI/CABG)was introduced as an adjusted factor,there was a significant association between survival rates and PCI/CABG rather than IABP.In stages D and E of CS,IABP was significantly associated with an improved survival at 1 month[adjusted OR(95%CI)=0.053(0.012-0.236),P=0.001].Therefore,IABP could assist patients with stage C of CS in the perioperative period of PCI/CABG and improve survival rates,and IABP might prolong short-term prognosis of patients with stages D and E of CS.

关 键 词：休克 心源性 主动脉内球囊反搏 美国心血管造影和介入学会 生存率 

分 类 号：R541.64[医药卫生—心血管疾病]