主动脉内球囊反搏在急性心肌梗死并泵衰竭患者不同时机的应用  

Different Timing Applications of Intra-aortic Balloon Counterpulsation for Patients with Acute Myocardial Infarction Complicated by Pump Failure

作　　者：潘宏伟[1] 郭莹[1] 郑昭芬[1] 何晋[1] 张宇[1] 刘征宇[1] 胡勇军[1] 彭建强[1] 

机构地区：[1]湖南省人民医院心内科,湖南省长沙市410005

出　　处：《中国动脉硬化杂志》2014年第1期65-68,共4页Chinese Journal of Arteriosclerosis

摘　　要：目的探讨急性心肌梗死后泵衰竭患者主动脉内球囊反搏(IABP)辅助治疗时机的选择对治疗效果的影响。方法急性心肌梗死并泵衰竭患者85例,按IABP应用的时机不同随机分为两组:必要IABP组42例,为经积极药物治疗后,收缩压仍然<90 mmHg,再行IABP术患者;即刻IABP组43例,为入院时确诊后立即行IABP术患者;两组同时尽快行急诊经皮冠状动脉介入术。比较两组门-球囊时间、术后1周以及3个月的生存率,测量两组术后1天、3个月的左心室射血分数。结果必要IABP组门-球囊时间明显大于即刻IABP组(96.7±31.2 min比78.3±35.6 min,P<0.05)。必要IABP组术后3个月生存率明显低于术后1周(57.1%比69.0%,P<0.05),并低于术后3个月即刻IABP组(57.1%比67.4%,P<0.05)。术后3个月两组的左心室射血分数值均进行性降低,必要IABP组下降幅度大于即刻IABP组(7.6%±3.5%比4.2%±3.1%,P<0.05)。结论急性心肌梗死并泵衰竭患者尽早使用IABP,能缩短血运重建时间,降低死亡率及保护左心室收缩功能。Aim To investigate the application opportunity of intra-aortic balloon pump （IABP） for patients with acute myocardial infarction （AMI） complicated by pump failure and its influence on therapeutic efficacy for these patients. Methods 85 patients with acute myocardial infarction complicated by pump failure were randomly divided into two groups according to application opportunity of IABP. Immediate IABP group（43 cases） underwent the IABP surgery immediately after diagnosis. Necessary IABP group （42 cases） after positive drugs therapy, whose systolic blood pressure remains 〈 90 mmHg, underwent IABP surgery. And all the patients underwent emergency percutaneous coronary intervention （PCI） as soon as possible. The difference of door-to-balloon time, survival rate of the 1 week and 3 month postoperative in two groups were compared, left ventricular ejection fraction （EF） of 1 day and 3 month were measured. Results Door-to- balloon time of necessary IABP group was significantly greater than the immediate IABP group （96. 7 ± 31.2 min vs 78. 3 ± 35.6 min, P 〈 0. 05）. The survival rate of necessary IABP group after 3 months was significantly lower than a week post operative （57. 1% vs 69. 0% ）, and lower than instantly IABP group （57. 1% vs 67.4% ）, there were significant differ ences （P 〈 0. 05）. EF of two groups after three months were continuously decreased, the necessary IABP group declined more than the immediate IABP group （7.6% ±3.5% vs4.2% ±3.1%, P〈0.05）. Conclusion Early useofIABP for patients with acute myocardial infarction complicated by pump failure, can shorten revascularization time, reduce mortality and protect left ventricular systolic function.

关 键 词：急性心肌梗死 泵衰竭 主动脉内球囊反搏 经皮冠状动脉介入术 

分 类 号：R5[医药卫生—内科学]