主动脉内球囊反搏对直接经皮冠状动脉介入治疗后无复流的急性广泛前壁心肌梗死患者心功能的影响  

Effect of intra-aortic balloon pump therapy on cardiac function in patients with no-reflow after primary percutaneous coronary intervention for extensive anterior acute myocardial infarction

作　　者：陈少敏[1] 马贵洲[1] 陈平[1] 罗燕华[1] 

机构地区：[1]汕头市中心医院心血管内科,广东汕头515031

出　　处：《岭南心血管病杂志》2016年第4期415-418,453,共5页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨主动脉内球囊反搏(intro-aortic balloon pump,IABP)对直接经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗后无复流的急性广泛前壁心肌梗死患者心功能的影响。方法分析2012年1月至2015年3月因急性广泛前壁心肌梗死行直接PCI治疗后无复流的患者54例,其中28例应用IABP治疗的作为实验组(IABP组),另外26例未应用IABP治疗的作为对照组;观察两组患者手术当天、术后第3天、1周、1个月的血浆B型脑钠肽(B-type brain natriuretic peptide,BNP)浓度,以及手术当天、术后1周、3个月、6个月的左心室舒张末期内径(left ventricular end-diastolic dimension,LVDd)、左心室射血分数(left ventricular ejection fraction,LVEF)。结果 IABP组术后第3天、1周、1个月的血浆BNP浓度低于对照组,差异有统计学意义(P<0.05);IABP组术后1周、3个月、6个月的LVDd小于对照组,差异有统计学意义(P<0.05);LVEF高于对照组,差异有统计学意义(P<0.05)。结论直接PCI治疗后无复流的急性广泛前壁心肌梗死患者及时应用IABP可有效改善心功能。Objectives To investigate the effect of intra-aortic balloon pump （IABP） therapy on cardiac function in patients with no-reflow （NF） phenomenon after primary percutaneous coronary intervention （PCI） for extensive anterior acute myocardial infarction. Methods Clinical data from January 2012 to March 2015 of 54 patients with NF phenomenon after primary PCI for extensive anterior acute myocardial infarction were retrospectively analyzed. Twenty- eight patients were performed IABP as experiment group （IABP group）, the other 26 patients without IABP therapy were served as control group. Plasma concentrations of B-type natriuretic peptide （BNP） in both groups immediately, 3, 7,30 days after intervention were observed. In addition, left ventricular end-diastolic dimension （LVDd） and left ventricular ejection fraction （LVEF） were evaluated immediately and 1 week, 3 mouths, 6 mouths after interventions. Results Plasma concentration of BNP in IABP group was significantly lower than that in control group 3,7,30 days after PCI （P〈O.05）. LVDd in IABP group was significantly lower than that in control group 1 week, 3 months, 6 months after PCI （P〈0.05）. LVEF in IABP group was significantly higher than that in control group. Conclusions IABP therapy applied in time effectively improves cardiac function in patients with NF phenomenon after primary PCI for extensive anterior acute myocardial infarction.

关 键 词：心肌梗死 主动脉内球囊反搏 无复流 经皮冠状动脉介入术 心功能 

分 类 号：R542.22[医药卫生—心血管疾病]