主动脉内球囊反搏介导血小板减少的临床分析  

Clinical analysis of thrombocytopenia in patients undergoing intra-aortic balloon pump

作　　者：周贻军[1] 赵亚男[1] 刘映峰[1] 缪绯[1] 

机构地区：[1]南方医科大学珠江医院心血管内科,广州510280

出　　处：《岭南心血管病杂志》2013年第3期269-271,共3页South China Journal of Cardiovascular Diseases

基　　金：创建海珠区原发性高血压科普教育基地[项目编号:KP2010(T)-11]

摘　　要：目的分析因急性心肌梗死和其他因素引起的急性心力衰竭需植入主动脉内球囊反搏(intra-aorticballoon pump,IABP)患者血小板减少的原因。方法回顾性分析2010年10月5日至2012年6月5日在南方医科大学附属珠江医院心血管内科植入IABP的61例患者的临床资料。结果 32例(52.5%,32/61)发生血小板减少症。血小板最低值出现在IABP植入后101.0 h。血小板减少症患者病死率高于未发生血小板减少症的患者,差异有统计学意义[37.5%(12/32)vs.13.8%(4/29),P=0.036]。使用40 CC球囊的患者血小板减少症发生率高于使用34 CC的患者,差异有统计学意义[61.9%(26/42)vs.31.6%(6/19),P=0.028]。女性血小板减少率高于男性,差异有统计学意义[80.0%(12/15)vs.43.5%(20/46),P=0.014]。心肌梗死患者和心力衰竭患者血小板减少症发生率比较,差异无统计学意义[46.2%(18/39)vs.63.9%(14/22),P=0.189]。结论血小板减少症的发生与使用大球囊、女性有关,其可增加患者住院病死率,但与疾病种类无关。Objectives To analyze the cause of thrombocytopenia in patients with acute heart failure induced by acute myocardial infarction and other factors implanted intra-aortic balloon pump （IABP）. Methods We calculated the incidence and assessed clinical end points of thrombocytopenia, using retrospectively collected data on 61 patients undergoing IABP in coronary care unit （CCU） of Zhujiang Hospital from October 2010 to June 2012. Results Thrombocytopenia （nadir〈lOO^lOg/L） occurred in 32 patients （52.5%, 32/61）. Platelet minimum value appeared at 101.0 h after IABP implantation. Incidence of in-hospital death was significantly higher among patients with thrombocytopenia than among those without [ 37.5 % （12/32） vs. 13.8% （4/29）, P=0.036 ]. Patients who were implanted 40 CC balloon had a significantly higher thrombocytopenia incidence rate than patients implanted 34 CC balloon [61.9%（26/42）vs.31.6%（6/19）,P=0.028]. Females were much easier than males to develop thrombocytopenia [ 80.0 % （ 12/15 ） vs. 43.5 % （20/46）, P=0.014 ]. Patients with myocardial infarction and those with heart failure had no significant difference in thrombocytopenia incidence [ 46.2% （18/39） vs. 63.9% （14/22）, P=0.189 ]. Conclusions High incidence of thrombocytopenia has a relationship with balloon types and gender （i.e. females） which can increase in-hospital death. Incidence of thromboeytopenia has nothing to do with diseases.

关 键 词：主动脉内球囊反搏 血小板减少症 心力衰竭 心肌梗死 

分 类 号：R540.46[医药卫生—心血管疾病]