择期PCI大面积STEMI患者术前应用IABP临床预后观察  

Effects of early application of IABP on clinical prognosis of STEMI patients with elective PCI

作　　者：李志娟[1] 董平栓[1] 杨旭明[1] 刘威[1] 王可[1] 李治国[1] 赵玉伟[1] 靳国青[1] 李转珍[1] 李春燕[1] 

机构地区：[1]河南科技大学第一附属医院,河南洛阳471003

出　　处：《山东医药》2012年第32期15-16,19,共3页Shandong Medical Journal

基　　金：河南省卫生厅科技攻关项目(201003080)

摘　　要：目的研究择期行经皮冠状动脉介入治疗(PCI)的大面积急性ST段抬高型心肌梗死(STEMI)患者早期应用主动脉内气囊反搏术(IABP)对临床预后的影响。方法选取发病12～72 h的STEMI患者100例,随机分为两组,IABP组52例、对照组48例,对照组给予规范的药物治疗,IABP组在规范药物治疗的基础上床旁应用IABP 3～5 d。两组均于10～14 d后行冠脉造影及PCI术。评价梗死相关血管PCI术前及术后冠脉血流(TIMI)和术后4周心功能及主要不良心脏事件的发生情况。结果 IABP组PCI术前、术后TIMIⅢ级高于对照组,PCI术后4周主要不良心脏事件的发生率低于对照组,左心室射血分数高于对照组,P均<0.05。结论对于大面积STEMI患者择期行PCI,早期应用IABP能改善梗死相关血管的TIMI血流,减少术后4周主要不良心脏事件的发生率,改善心功能,临床应用安全有效。Objective To evaluate the effect of early application of intra-aortic balloon pump counterpulsation （IABP） on patients with ST-segment elevation acute myocardial infarction （STEMI） for elective percutaneous coronary in terventional （PCI）. Methods One hundred STEMI patients were randomized into test group （ n = 52） and control group （n =48）. All the individuals onset of STEMI had been 12-72 hours. The patients in test group received IABP support treatment for 3-5 days. All the individuals were performed PCI after 10-14 days. Thrombolysis in acute myocardial infarc tion （TIMI） grade was studied before and after PCI. The major adverse cardiac events （MACE） and heart function at 4 weeks were studied. Result In test group, TIMI flow rate was significantly higher than that in control group after PCI （ P 〈 0.05 ）, the occuranee of MACE at 4 weeks was significantly lower than that in control group （ P 〈0.05 ）, and left ventricle ejection fraction （LVEF） was significantly higher than that in control group （P 〈 0.05）. Conclusion Early ap plication of IABP on patients with STEMI for elective PCI is safe and effective, which can reduce the occuranee of MACE at 4 weeks, and improve LVEF.

关 键 词：主动脉内气囊反搏 心肌梗塞 血管成形术 经腔 经皮冠状动脉 

分 类 号：R541.4[医药卫生—心血管疾病]