前降支CTO伴低射血分数的血运重建患者预防性应用IABP的疗效  

Effect of prophylactic use of intra-aortic balloon pump in the low ejection fraction patients with chronic total occlusion of anterior descending coronary artery undergoing percutaneous coronary intervention

作　　者：陈少敏[1] 王文亮[1] 马贵洲[1] 徐荣和[1] 朱稚丹[1] 陈平[1] 

机构地区：[1]汕头市中心医院/中山大学附属汕头医院心血管内科,广东汕头515031

出　　处：《现代医学》2016年第6期772-776,共5页Modern Medical Journal

基　　金：汕头市医疗科技计划项目(汕府科[2014]62号-14)

摘　　要：目的:评价主动脉内球囊反搏(IABP)预防性应用于前降支慢性完全闭塞(CTO)伴低射血分数[左心室射血分数(LVEF)≤35%]的经皮冠状动脉介入(PCI)治疗患者的临床疗效。方法:选择2010年1月至2014年6月行PCI血运重建的前降支CTO伴低射血分数患者52例,根据是否于PCI前预防性应用IABP治疗分为治疗组(n=26)及对照组(n=26),观察两组患者术中并发症及住院期间心血管事件发生率;术前及术后1、3、12个月的左心室舒张末期内径(LVDd)、LVEF;并随访1年,观察两组患者的主要心血管不良事件(MACE)发生情况。结果:治疗组术中并发症及住院期间心血管事件总发生率低于对照组,差异有统计学意义(P<0.05);治疗组术后1、3、12个月的LVDd小于对照组,而LVEF高于对照组,差异有统计学意义(P<0.05);术后1年内治疗组充血性心力衰竭发生率及再次住院率低于对照组,差异有统计学意义(P<0.05)。结论:前降支CTO伴低射血分数患者PCI血运重建前预防性应用IABP可有效降低术中并发症及住院期间心血管事件总发生率,改善心功能,并降低患者1年内充血性心力衰竭发生率及再次住院率。Objective： To investigate the effect of prophylactic use of intra-aortic balloon pump（ IABP） in the low ejection fraction（ LVEF≤35%） patients with chronic total occlusion（ CTO） of anterior descending coronary artery undergoing percutaneous coronary intervention（ PCI）. Methods： 52 cases with low ejection fraction and CTO of anterior descending coronary artery underwent PCI between January 2010 and June 2014 were divied into two group,26 patients were performed with IABP preoperation（ treatment group）,the other 26 patients were not performed with IABP preoperation（ control group）. Observed the incidence of complication during operation and cardiovascular events in hospitalization period in both groups; Observed the left ventricular end diastolic dimension（ LVDd）,the left ventricular ejective fraction（ LVEF） in both groups before the operation and in 1,3 and 12 mouths after the operation; In adition,the major adverse cardiac events（ MACE） in both groups within 1 year were observed. Results： Incidence of complication during operation and cardiovascular events in hospitalization period in experimental group was significantly lower than that in control group（ P〈0. 05）; LVDd in experimental group was significantly lower than that in control group in 1,3 and 12 mouths（ P〈0. 05）,while LVEF in experimental group was significantly higher than that in control group in 1,3 and 12 mouths（ P〈0. 05）. Follow-up 1 year,the incidence of congestive heart failure in experimental group and rehospitalization rate were lower than those in control group（ P〈0. 05）. Conclusion： The prophylactic use of IABP can effectively induce the incidence of complication during operation and cardiovascular events in hospitalization period,and improve the cardiac function in low ejection fraction patients with CTO of anterior descending coronary artery undergoing PCI, also reduce the occurrence of congestive heart failure and rehospitalization rate in 1 year.

关 键 词：前降支 慢性完全闭塞 低射血分数 主动脉内球囊反搏 经皮冠状动脉介入 

分 类 号：R541.4[医药卫生—心血管疾病]