主动脉球囊反搏术对急性心肌梗死并发心源性休克患者冠状动脉介入术后C反应蛋白水平的影响  

Influences of intra-aortic balloon pump support in patients with acute myocardial infarction complicated by cardiogenic shock undergoing percutaneous coronary intervention upon C reactive protein levels

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,上海201100

出　　处：《临床心血管病杂志》2009年第7期497-499,共3页Journal of Clinical Cardiology

摘　　要：目的:评价急性心肌梗死(AMI)并发心源性休克患者行急诊介入治疗(PCI)时主动脉球囊反搏术(IABP)对术后C反应蛋白(CRP)水平的影响。方法:43例在IABP支持下行急诊PCI的并发心源性休克的AMI患者为IABP组,将同期行急诊PCI但没有行IABP支持的合并心源性休克的AMI患者48例设为对照组;入院后分别测定入院时以及第3天、第7天的CRP水平;比较2组PCI术后TnI峰值,术后2周、3个月的左室射血分数,随访患者术后3个月的病死率。结果:2组患者入院时的CRP水平无明显差异,而第3天、第7天的CRP水平IABP组明显低于对照组[(80.3±42.8)∶(98.9±31.6)mg/L,(70.6±34.3)∶(85.8±25.8)mg/L;均P<0.05];IABP组患者术后TNI峰值明显低于对照组[(21.6±4.1)∶(23.7±4.6)ng/ml,P<0.05],术后2周、3个月的左室射血分数较对照组明显改善[(44.7±7.3)%∶(40.5±6.2)%,(45.1±6.6)%∶(40.7±4.4)%;均P<0.05];而IABP组术后3个月内的病死率明显降低(P<0.05)。结论:对并发心源性休克的AMI患者行急诊PCI术同时采用IABP支持治疗能明显降低术后CRP水平,并能有效地改善左室功能和降低术后3个月内病死率。Objective：To assess the effects of intra-aortic balloon pump （IABP） support in patients with acute myocardial infarction （AMI） complicated by cardiogenic shock （CS） undergoing percutaneous coronary intervention （PCI） upon C reactive protein （CRP） levels. Method： The clinical data of 43 patients with AMI complicated by CS receiving emergency PCI with IABP support were enrolled, and 48 patients receiving emergency PCI without IABP support at the same time were included as the control group. The CRP levels were determined at the admittance, day 3 and day 7 respectively. TNI peak was compared between two groups. Two weeks and three months after operation, the two groups were compared for left ventricular functions. The mortality rate was also evaluated three months after operation. Result：Patients receiving IABP support had lower CRP levels at day 3 and day 7（[80.3±42.8]mg/L vs [98.9±31.6] mg/L ,[70.6±34.3]mg/L vs [85.8±25.8]mg/L; both P〈0.05）, but no signifioant difference at admittance; it also had a greater improvement in the left ventricular function at 2- week and 3-month following operation （[44. 7±7. 3] vs[00 vs [40.5 ±6.21%, [45.1± 6.6] % vs [40.7 ± 4.4]% ; both P〈0.05） and lower TNI peak （[21.6±4. 1]ng/ml vs [23.7±4.6]ng/ml, P〈0.05）. Significantly differences were also observed in incidence of mortality at 3-month after operation （P〈0.05）. Conclusion： Patients undergoing PCI for AMI with CS can benefit from IABP support in terms of decreasing CRP levels, improving left ventricular functions and reducing mortality rate.

关 键 词：心肌梗死 主动脉内气囊泵 心室功能 左 C反应蛋白质 

分 类 号：R654.2[医药卫生—外科学] R542.22[医药卫生—临床医学]