主动脉球囊反搏在急性冠脉综合征患者的应用效果及性别差异研究  

Gender Differences and Outcomes of Intra Aortic Balloon Counterpulsation Support in Patients with Acute Coronary Syndrome

作　　者：陆铭 梁春[2] 任雨笙[2] 潘晓明[2] 樊民[2] 杨靖[2] 吴宗贵[2] 

机构地区：[1]上海市浦东医院心血管内科,201399 [2]第二军医大学长征医院心血管内科

出　　处：《中国全科医学》2013年第11期1234-1237,共4页Chinese General Practice

摘　　要：目的探讨主动脉球囊反搏(IABP)在急性冠脉综合征患者治疗中的应用效果及性别差异。方法回顾性选择2005年1月—2011年1月急性冠脉综合征并植入IABP患者76例,分为女性组(24例)和男性组(52例),比较两组患者的基线特征和临床情况,分析其在院期间及随访1年的预后。结果与男性组相比,女性组年龄明显增大,糖尿病发生率明显增多,吸烟率明显降低,差异均有统计学意义(P<0.05)。76例应用IABP患者中,在院死亡率28.9%(22/76),随访1年死亡率38.2%(29/76)。女性组与男性组在院死亡率(41.7%和23.1%)和随访1年死亡率(45.8%和34.6%)间差异无统计学意义(P>0.05)。Kaplan-Meier生存曲线显示,女性组院内及随访1年生存率与男性组比较,差异无统计学意义(P=0.059,P=0.192)。院内死亡和存活患者的年龄、经皮冠状动脉介入治疗(PCI)后血流分级、左室射血分数(LVEF)比较,差异有统计学意义(P<0.05),随访1年死亡和存活患者以上指标间差异亦均有统计学意义(P<0.05)。多因素Logistic回归分析显示,年龄、LVEF、PCI后的TIMI血流分级是影响院内和随访1年预后的独立危险因素。结论联合IABP治疗的ACS患者院内及随访1年的预后良好。应用IABP的女性ACS患者年龄大,伴发疾病多,但院内、1年死亡率间无明显性别差异。Objective To investigate gender difference and outcomes in acute coronary syndrome （ACS） patients treated with intra aortic balloon pump eounterpulsation （IABP）. Methods Clinical data about 76 ACS patients who underwent IABP placement from January 2005 to January 2011 in our hospital were retrospectively analyzed. The patients were divided into female group （ n = 24） and male group （ n = 52）. The baseline data and clinical outcomes were compared between two groups. Their prognosis in hospital and 1 - year after discharge was analyzed. Results Among 76 ACS patients treated with IABP, in - hospital mortality was 28. 9% , 1 -year mortality was 38.2%. Female patients were significantly older than male patients, had a higher incidence of diabetes mellitus, but the incidence of smoking was less in the female group than in the male group. There were no significant difference in in - hospital mortality （41.7% vs. 23.1%, P = O. 11 ） and one - year mortality （45.8% vs. 34. 6%, P = 0. 45 ） between two groups. Kaplan - Meier analysis showed no significant difference between two groups （ in - hospital P = 0. 059; 1 -year P = 0. 192）. Patients who died during hospitalization and died in one year after discharge appears higher age, lower Left ventricular ejective factor （LVEF） and a higher percentage of patients with lower TIMI flow grade after percutaneous coronary intervention （PCI）. Multivariables analysis showed that age, TIMI flow grade after PCI, and LVEF were independent risk factors of death. Conclusion Patients with ACS who underwent primary PCI assisted by IABP have a favorable in -hospital and one -year outcome. Female patients with ACS treated with IABP were older than male patients and had more concomitant diseases. However, there were no significant difference in in - hospital mortality and one - year mortality between the female and male group.

关 键 词：主动脉球囊反搏 急性冠脉综合征 性别 治疗结果 

分 类 号：R541.4[医药卫生—心血管疾病]