Impella LP 2.5辅助高危冠心病患者介入治疗的临床观察  

A prospective,investigating clinical trial of Impella LP 2.5 in complex high-risk percutaneous coronary intervention

作　　者：肖文涛 张静 郭素萍 王宪沛 齐大屯 叶发民 张优 高传玉 XIAO Wentao;ZHANG Jing;GUO Suping;WANG Xianpei;QI Datun;YE Famin;ZHANG You;GAO Chuanyu(Coronary Care Unit,Fuwai Central China Cardiovascular Hospital,Zhengzhou,451464,China;Department of Cardiology,Fuwai Central China Cardiovascular Hospital;Henan Institute of Cardiovascular Epidemiology)

机构地区：[1]阜外华中心血管病医院冠心病重症监护室,郑州451464 [2]阜外华中心血管病医院冠心病病区 [3]河南省心血管流行病学研究中心

出　　处：《临床心血管病杂志》2022年第2期162-166,共5页Journal of Clinical Cardiology

基　　金：河南省医学科技攻关计划项目(No:201602210)。

摘　　要：随着社会经济的发展,急性冠状动脉综合征(ACS)患者逐渐呈现老龄化、复杂化,早期成功的血运重建仍是此类患者1年生存率的唯一独立预测因素[1],其中10%~15%为高危冠心病患者,且多数患者难以耐受或无法等待外科冠状动脉移植手术(CABG),从而对心脏介入医生及重症医生提出了更高的挑战[2]。Objective:To evaluate the clinical safety and feasibility of Impella LP 2.5 in patients undergoing high-risk percutaneous coronary intervention(PCI).Methods:The 6 patients with high-risk PCI percutaneously implanted Impella LP 2.5 before,clinical and laboratory examinations were performed at baseline as well as the application process of Impella and at 1 year after discharge.Results:①Impella LP 2.5 insertion was successful in all patients without obvious complications.②The mean arterial pressure(MAP)increased by 2.6 mmHg at 1 hour after Impella implantation(P=0.014)and PCI was performed uneventfully in all patients.③The 5 patients were weaned and discharged smoothly but 1 patient died of refractory heart failure occurred 6 days after the intervention.④The average hospitalization time in coronary care unit(CCU)was(3.5±2.5)days and(4.5±2.4)days in general ward with(375±48)thousand yuan per patient.⑤All discharged patients were followed up successfully and 1 patient was hospitalized again due to heart failure 74-day and 277-day after discharge and died 310-day,others have good functional status,accounting for total 1-year mortality of 66.7%.⑥Comparing with that of before procedure,left ventricular ejection fraction(LVEF)and BNP level of the surviving patients were significantly improved at 6 months and 12 months after discharge(P<0.05).Conclusion:mpella LP 2.5 may be a safe and promising approach for high-risk PCI patients,large randomized trials are warranted to ascertain the clinical safety and feasibility.

关 键 词：冠心病 经皮冠状动脉介入治疗 Impella LP 2.5 病死率 

分 类 号：R542.2[医药卫生—心血管疾病]