主动脉内球囊反搏术在急性心肌梗死合并心源性休克患者冠状动脉介入术中的疗效评估  

Therapeutic efficacy of intra-aortic balloon pump support in patients with acute myocardial infarction complicated by cardiogenic shock undergoing percutaneous coronary intervention

作　　者：顾俊[1] 胡伟[1] 肖红兵[1] 冯小弟[1] 余强[1] 金贤[1] 尹桂芝[1] 陈诚军[1] 陈跃光[1] 张大东[1] 

机构地区：[1]上海瑞金医院集团闵行区中心医院心内科,201100

出　　处：《中国介入心脏病学杂志》2009年第1期9-11,共3页Chinese Journal of Interventional Cardiology

摘　　要：目的评价急性心肌梗死合并心源性休克患者行急诊介入治疗时常规主动脉内球囊反搏术(IABP)的可行性及有效性。方法41例在IABP支持下行急诊介入治疗的合并心源性休克的急性心肌梗死患者为治疗组,将同期行急诊介入治疗但没有行IABP支持的合并心源性休克的急性心肌梗死患者47例设为对照组;比较两组术后2周、3个月的左室功能,评价2组术后30天以及3个月的MACE事件发生率。结果IABP组患者术后2周、3个月的左室功能较对照组明显改善(43.8%±8.2%比39.4%±5.9%,45.5%±6.6%比40.6%±4.6%,P均<0.05);两组患者术后30天(16/41比30/47)、3个月(18/41比33/47)的MACE事件差异也有统计学意义(P均<0.05),其中IABP组在降低术后30天、3个月的死亡率方面尤为明显(30天16/41比对照组30/47,3个月18/41比对照组33/47,P均<0.05)。结论对合并心源性休克的急性心肌梗死患者行急诊PCI同时采用IABP支持治疗能有效改善左室功能和减少主要心血管不良事件的发生率。Objective To assess the value of intra-aortic balloon pump （IABP） support in patients with acute myocardial infarction （AMI） complicated by cardiogenic shock （CS） undergoing percutaneous coronary intervention （PCI）. Methods The clinical data of 41 patients with AMI complicated by CS receiving emergency PCI with IABP support were retrospectively reviewed, and 47 patients receiving emergency PCI without IABP support at the same time were included as the control group. Left ventricular function was evaluated in the 2 groups at 2 weeks and at 3 months after the operation respectively. The incidence of MACE was compared between the 2 groups at 30 days and also at 3 months after the operation. Results Patients receiving IABP support had greater improvement in left ventricular function at 2-week and 3-month after operation （43.8 ± 8.2% vs 39. 4 ± 5.9%, 45. 5 ± 6. 6 vs 40. 6 ± 4. 6%, both P 〈 0. 05 ）. Differences were also observed in incidence of MACE （16/41 vs 30/47, 18/41 vs 33/47, both P 〈 0. 05） , espeeially in the mortality rate at 30-day and 3-month after operation （ 16/41 vs 30/47, 18/41 vs 33/47, both P 〈 0. 05 ）. Conclusion Patients undergoing PCI for AMI with CS can benefit from IABP support in terms of improvement in left ventricular function and reduced rate of MACE.

关 键 词：心肌梗死 休克 主动脉内球囊反搏 

分 类 号：R542.22[医药卫生—心血管疾病] R472.9[医药卫生—内科学]