IABP联合急诊PCI术对急性心肌梗死后心源性休克患者平均动脉压、乳酸水平的影响  

Effects of IABP combined with emergency PCI on mean arterial pressure and lactate level in patients with cardiogenic shock after acute myocardial infarction

作　　者：孙天保 贺莹 高鹏燕 苏京[1] 马欣 SUN Tian-bao;HE Ying;GAO Peng-yan;SU Jing;MA Xin(Cardiovascular Center,Beijing Tongren Hospital,Capital Medical University,Beijing 100730;Department of Cardiology,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]首都医科大学附属北京同仁医院心血管中心,北京100730 [2]北京大学第一医院心血管内科,北京100034

出　　处：《川北医学院学报》2020年第3期417-419,427,共4页Journal of North Sichuan Medical College

基　　金：北京市自然科学基金(7172063)。

摘　　要：目的:探讨主动脉内球囊反搏术(IABP)联合急诊经皮冠状动脉介入术(PCI)对急性心肌梗死(AMI)后心源性休克患者平均动脉压、乳酸水平的影响。方法:按数表法,将80例AMI心源性休克患者随机分为观察组和对照组,每组各40例。对照组采用急诊PCI治疗,观察组采用IABP联合急诊PCI治疗。治疗后,观察两组患者中心静脉压(CVP)、平均动脉压(MAP)、左心室射血分数(LVEF)等血流动力学指标,血清乳酸(LAC)、超敏C反应蛋白(hs-CRP)、脑钠肽(BNP)水平,不良事件发生情况及患者存活率。结果:与对照组相比,观察组治疗后CVP更低,MAP与LVEF更高,血清LAC、hs-CRP、BNP水平均更低,心律失常、心力衰竭、心肌梗死复发率均更低,患者存活率更高,差异均有统计学意义(P<0.05)。结论:采用IABP联合急诊PCI治疗AMI心源性休克患者可改善患者血流动力学指标,降低血清LAC、hs-CRP、BNP水平,减少不良事件发生,改善预后。Objective:To investigate the effect of intra-aortic balloon counterpulsation(IABP)combined with emergency percutaneous coronary intervention(PCI)on mean arterial pressure and lactate level in patients with cardiogenic shock after acute myocardial infarction(AMI).Methods:80 patients with cardiogenic shock after AMI treated were randomly divided into observation group(n=40)and control group(n=40).The control group was treated with emergency PCI,and the observation group was treated with IABP combined with emergency PCI.The hemodynamic parameters such as central venous pressure(CVP),mean arterial pressure(MAP),left ventricular ejection fraction(LVEF),serum lactic acid(LAC),hypersensitive C-reactive protein(hs-CRP),brain natriuretic peptide(BNP),adverse events and survival rate were observed and compared between the two groups after treatment.Results:Compared with the control group,the observation group had lower CVP,higher MAP and LVEF,lower serum levels of LAC,hs-CRP and BNP,lower recurrence rate of arrhythmia,heart failure and myocardial infarction,and higher survival rate,the differences were statistically significant(P<0.05).Conclusion:IABP combined with emergency PCI can improve the hemodynamic indexes of patients with cardiogenic shock after AMI,reduce the levels of serum LAC,hs-CRP and BNP,reduce the incidence of adverse events and improve the prognosis.

关 键 词：急性心肌梗死 主动脉内球囊反搏术 经皮冠状动脉介入术 心源性休克 平均动脉压 乳酸 

分 类 号：R542.2[医药卫生—心血管疾病]