主动脉球囊反搏辅助经皮冠脉介入治疗急性心梗合并心衰患者的疗效分析  

Efficacy of intra-aortic balloon pump combined with percutaneous coronary intervention in patients with acute myocardial infarction combined with heart failure

作　　者：雷结 朱伦华 刘洪俊[1] LEI Jie;ZHU Lunhua;LIU Hongjun(Department of Cardiovascular Medicine,Linquan County People's Hospital,Fuyang Anhui 236499,China)

机构地区：[1]临泉县人民医院心血管内科,安徽阜阳236499

出　　处：《中国急救复苏与灾害医学杂志》2022年第10期1273-1277,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：安徽省科技计划项目(编号:12010402C227)。

摘　　要：目的 探讨主动脉球囊反搏联合经皮冠脉介入治疗急性心肌梗死与只使用经皮冠脉介入治疗急性心肌梗死的疗效比较。方法 收集2018年1月—2021年12月于临泉县人民医院急诊科收治后转入心血管内科的急性心肌梗死的62名患者为研究对象。试验组31例为进行经皮冠状动脉介入治疗后增加使用主动脉内球囊反搏术(IABP)的患者,对照组31例为仅用经皮冠状动脉介入治疗的患者。从心肌酶谱指标、心衰指标、心脏彩超指标和不良反应发生率这四个方面对试验组和对照组在使用IABP治疗和未用IABP治疗后的疗效进行检测。结果对照组和试验组两组在一般资料方面两组间比较无显著差异(P>0.05)。在心肌酶谱指标方面,对照组的肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I (cTnI)分别为(35.52±3.33)U/L、(32.32±3.00)μg/mL;试验组的CKMB、cTnI分别为(21.48±6.69)U/L、(19.61±4.03)μg/mL;两组比较有显著差异(P<0.05)。心衰指标方面,对照组N末端B型利钠肽原(NT-proBNP)、C-反应蛋白(CRP)和血清肌酐(Cr)分别为(4 154.68±185.51)pg/mL、(19.26±1.49)mg/L、(102.76±16.64)μmol/L试验组的NT-proBNP、CRP、Cr分别为(3 643.94±220.01)pg/mL、(16.26±2.06)mg/L、(85.85±11.99)μmol/L,两组相比差异具有统计学意义(P<0.05)。心脏彩超指标方面,对照组和试验组的SV、LVEF、LVEDD分别为(68.87±5.77)mL和(77.90±5.55)mL、(42.79±3.77)%和(46.99±3.22)%、(61.46±7.25)mm和(54.79±10.23)mm,两组相比差异具有统计学意义(P<0.05)。结论 相比仅通过经皮冠脉介入治疗,在经皮冠脉介入治疗的基础上外加使用主动脉内球囊反搏会减少手术对急性心肌梗死合并心力衰竭患者心肌的损伤,缓解患者的心脏负荷,减少不良反应的发生,给患者带来较好的预后。ObjectiveTo investigate the efficacy of aortic balloon pumping combined with percutaneous coronary intervention in treating acute myocardial infarction and percutaneous coronary intervention alone in treating acute myocardial infarction.Methods62 patients with acute myocardial infarction admitted to the Department of Cardiovascular Medicine after being admitted to the emergency department of Linquan County People’s Hospital from January 2018 to December 2021 were collected as research subjects.31 patients in the experimental group were treated with an intra-aortic balloon pump(IABP)after percutaneous coronary intervention,and 31 patients in the control group were treated with only percutaneous coronary intervention.The therapeutic effects of the experimental and control groups after IABP treatment and without IABP treatment were detected from four aspects:myocardial enzyme spectrum index,heart failure index,cardiac colour Doppler ultrasound index and incidence of adverse reactions.ResultsThere was no significantdifferencein generaldatabetween thecontroland experimentalgroups(P>0.05).In termsofmyocardialenzymes,the creatine kinase isoenzymes(CK-MB)and cardiac troponin I(cTnI)of the control group were(35.52±3.33)U/L.(32.32±3.00)μg/mL respectively;CK-MB and cTnI in the experimental group were(21.48±6.69)U/L and(19.61±4.03)μg/mL,respectively.There was a significant difference between the two groups(P<0.05).In terms of heart failure indicators,Nterminal-pro hormone BNP(NT-proBNP),CRP and Cr the control group in were(4154.68±185.51)pg/mL,(19.26±1.49)mg/L,(102.76±16.64)μmol/L respectively,the experimental group’s NT-proBNP,C-reactive protein(CRP)and serum creatinine(Cr)were(3643.94±220.01)pg/mL,(16.26±2.06)mg/L,(85.85±11.99)μmol/L.The difference between the two groups was statistically significant(P<0.05).In terms of cardiac colour Doppler ultrasound indicators,the SV、LEF、LVEDD of the control group and the experimental group were(68.87±5.77)mL and(77.90±5.55)mL,(42.79±3.77)%and(46.99±3.22)%,(61

关 键 词：急性心肌梗死 心力衰竭 主动脉球囊反搏 经皮冠脉介入治疗 

分 类 号：R654.2[医药卫生—外科学]