主动脉内球囊反搏在急诊经皮冠状动脉介入治疗高血栓负荷病变合并慢血流中的应用研究  

Study of intra-aortic balloon pumping on emergency percutaneous coronary intervention with high thrombus burden combined slow flow phenomenon

作　　者：白玉鹏[1] 胡立群[1] 余德龙[1] 刘晓刚[1] 彭晟[1] 王红[1] 顾晔[1] 

机构地区：[1]华中科技大学同济医学院附属普爱医院心血管内科,武汉430033

出　　处：《临床心血管病杂志》2015年第6期604-608,共5页Journal of Clinical Cardiology

基　　金：湖北省自然科学基金项目(No:2011CDB309);湖北省青年基金项目(No:2014CFB365)

摘　　要：目的:探讨主动脉内球囊反搏(IABP)在急性心肌梗死(AMI)急诊冠状动脉(冠脉)介入治疗高血栓负荷合病变合并慢血流中的治疗作用。方法:分析自2008-06-2014-06期间因AMI行PTCA术后高血栓负荷合并慢血流的患者53例,采用单双日分组方法将其中26例运用IABP治疗,其余27例未用IABP作为对照组,1周后行支架植入术并随访6个月,用矫正的冠脉血流帧数(CTFC)评价冠脉血流,并观察血浆vWF以及ET-1浓度和心肌损伤标志物(cTnI)、脑钠肽(BNP)变化及心功能恢复情况。结果:IABP治疗明显改善了支架植入前患者的冠脉血流(CTFC明显降低)以及1周、6个月的心功能水平(P<0.05),1周后IABP组患者血浆vWF以及ET-1浓度明显低于对照组(P<0.05),1周后的BNP、cTnI与对照组相比,也有明显降低(P<0.05)。结论:及时采用IABP治疗可使急诊经皮冠脉介入治疗高血栓负荷病变合并慢血流患者冠脉血流、心功能得到一定程度改善。Objective：To research the effects of intra-aortic balloon pumping（IABP）on slow coronary flow phenomenon in emergency percutaneous coronary intervention combined with high thrombus burden.Method：Clinical acute myocardial infarction patients after PTCA with angiographic slow flow combined with high thrombus burden（53cases）between 2008 to 2014were divided into two groups using odd day methed：26patients were performed IABP,and the other 27 patients as control group.All selected patients underwent coronary artery stents implantation 1week later,with a 6month follow-up.The coronary flow was evaluate by corrected TIMI Frame Count and the differences of Plasma vWF,ET-1,cTnI,BNP concentration and cardiac ventricle systolic function between two groups were observed.Result：IABP treatment significantly improved the coronary blood flow before stenting（CTFC decreased evidently）and the cardiac function at both 1week and 6 months.vWF and ET-1decreased much rapidly in IABP groups than those in the control groups（P〈0.05）.Cardiac injury markers cTnI and BNP in IABP group were decreased significantly（P〈0.05）.Conclusion：Timely IABP treatment can improve coronary flow and cardiac function in emergency percutaneous coronary intervention with high thrombus burden combined with slow flow phenomenon.

关 键 词：高血栓负荷 主动脉内球囊反搏 慢血流现象 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]